{"data":{"id":"us-va/18vac90-70-140","jurisdiction":"us-va","citation":"18VAC90-70-140","heading":"Evaluation of the patient for acute pain","body":"A. The requirements of this part shall not apply to:\n\n1. The treatment of acute pain related to (i) cancer, (ii) sickle cell, (iii) a patient in hospice care, or (iv) a patient in palliative care;\n\n2. The treatment of acute pain during an inpatient hospital admission or in a nursing home or an assisted living facility that uses a sole source pharmacy; or\n\n3. A patient enrolled in a clinical trial as authorized by state or federal law.\n\nB. Nonpharmacologic and non-opioid treatment for pain shall be given consideration prior to treatment with opioids. If an opioid is considered necessary for the treatment of acute pain, the practitioner shall give a short-acting opioid in the lowest effective dose for the fewest possible days.\n\nC. Prior to initiating treatment with a controlled substance containing an opioid for a complaint of acute pain, the prescriber shall perform a history and physical examination appropriate to the complaint, query the Prescription Monitoring Program as set forth in § 54.1-2522.1 of the Code of Virginia, and conduct an assessment of the patient's history and risk of substance misuse as a part of the initial evaluation.","path":["Title 18. Professional And Occupational Licensing","Agency 90. Board of Nursing","Chapter 70. Regulations Governing the Practice of Licensed Certified Midwives","Part V. Management of Acute Pain"],"source_url":"https://law.lis.virginia.gov/admincode/title18/agency90/chapter70/section140/","current_through":"2026 Regular Session (effective July 1, 2026)","vintage":"","retrieved_at":"2026-09-14T04:52:54Z","sha256":"ea6361d5651a0e46f0df4294bd4b29869faa644ba8c8f36ceb00064611a30a17","source_id":"us-va-vac","stale":false,"prev":"us-va/18vac90-70-130","next":"us-va/18vac90-70-150"},"notice":"GroundRules: Original legal text. Not legal advice."}