{"data":{"id":"us-va/18vac90-40-220","jurisdiction":"us-va","citation":"18VAC90-40-220","heading":"Opioid therapy for chronic pain","body":"A. The practitioner shall review the course of pain treatment and any new information about the etiology of the pain or the patient's state of health at least every three months.\n\nB. Continuation of treatment with opioids shall be supported by documentation of continued benefit from the prescribing. If the patient's progress is unsatisfactory, the practitioner shall assess the appropriateness of continued use of the current treatment plan and consider the use of other therapeutic modalities.\n\nC. Practitioners shall check the Prescription Monitoring Program at least every three months after the initiation of treatment.\n\nD. The practitioner shall order and review a urine drug screen or serum medication levels at the initiation of chronic pain management and  thereafter randomly at the discretion of the practitioner but at least  once a year.\n\nE. The practitioner shall regularly evaluate for opioid use disorder and shall initiate specific treatment for opioid use disorder, consult with an appropriate health care provider, or refer the patient for evaluation for treatment if indicated.","path":["Title 18. Professional And Occupational Licensing","Agency 90. Board of Nursing","Chapter 40. Regulations for Prescriptive Authority for \nAdvanced Practice Registered Nurses","Part VI. Management of Chronic Pain"],"source_url":"https://law.lis.virginia.gov/admincode/title18/agency90/chapter40/section220/","current_through":"2026 Regular Session (effective July 1, 2026)","vintage":"","retrieved_at":"2026-09-14T04:52:53Z","sha256":"386c0fb86954dfb524e09d027b5c3b0a8817f8b86e8b2631ab060202eb4e5ece","source_id":"us-va-vac","stale":false,"prev":"us-va/18vac90-40-210","next":"us-va/18vac90-40-230"},"notice":"GroundRules: Original legal text. Not legal advice."}