(a) At the time of the issuance of the third prescription for a Schedule II opioid drug the practitioner shall consider referring the patient to a pain clinic or a pain specialist. The practitioner shall discuss the benefits of seeking treatment through a pain clinic or a pain specialist and provide him or her with an understanding of any risks associated by choosing not to pursue that as an option. e (b) If the patient declines to seek treatment from a pain clinic or a pain specialist and opts to remain a patient of the practitioner, and the practitioner continues to prescribe a Schedule II opioid drug as provided in this code, the practitioner shall: u (1) Note in the patient's medical records that the patient knowingly declined treatment from a pain clinic or pain specialist; (2) Review, at a minimum of every three months, the course of treatment, any new information about the etiology of the pain, and the lpatient's progress toward treatment objectives and document the results of that resview; (3) Assess the patient prior to every renewial to determine whether the patient is experiencing problems associated with physical and psychological dependence and document the results of that assessment; and (4) Periodically make reasonable efforts, unless clinically contraindicated, to either stop the use of the controlled substance, decrease the dosage, try other drugs or treatment modalities in an effort to reduce the potential for abuse or the development of physical or psychological dependence, and document with specificity the efforts undertaken.
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