https://colorado.gov/pacific/dora/Acupuncture

COLORADO ACUPUNCTURE LAW AS IT RELATED TO POINT INJECTION THERAPY

Colorado Revised Statutes 2016

Title 12 Professions and Occupations

Article 29.5 Acupuncturists

Acupuncture Practice Act

12-29.5-102. Definitions.

(3.3) “Injection therapy” means the injection of sterile herbs, vitamins, minerals,

homeopathic substances, or other similar substances specifically manufactured for

nonintravenous injection into acupuncture points by means of hypodermic needles used primarily for the treatment of musculoskeletal pain. Permissible substances include saline, glucose, lidocaine, procaine, oriental herbs, vitamin B-12, traumeel, sarapin, and homeopathic substances. “Injection therapy” includes the use of epinephrine and oxygen as necessary for patient care and safety, including for the purpose of addressing any risk of allergic reactions when using injection substances.

12-29.5-102.5. Injection therapy – training – substances – rules. (1) A licensee shall obtain the necessary training as determined by the director prior to practicing injection therapy.

(2) Notwithstanding section 12-42.5-305, a licensee who has received the necessary

training to practice injection therapy may obtain substances for injection therapy from a registered prescription drug outlet, registered manufacturer, or registered wholesaler. An entity that provides a substance to a licensee in accordance with this section, and who relies in good faith upon the license information provided by the licensee, is not liable for providing the substance.

(3) The director shall promulgate rules to implement this section that include the

necessary training for a licensee to practice injection therapy and a list of substances that a licensee may obtain for injection therapy. In promulgating the rules, the director shall consult with knowledgeable medical professionals and pharmacists.

12-29.5-115. Effective date – applicability. This article shall take effect July 1, 1989,

and shall apply to practicing acupuncturists on or after January 1, 1990.

Colorado Acupuncture Rules and Regulations

https://drive.google.com/file/d/0BzKoVwvexVATVzljQ0lBX2hvM00/view

Rule 10 Injection Therapy

1. Definitions. For purposes of this rule only:
2. The Director recognizes that “Injection therapy” is the stimulation of acupuncture points, including trigger points(historically known as “AHSHI” points), by the injection of saline, sterile herbs, vitamins, minerals, homeopathic substances, glucose, lidocaine, procaine, and sarapin, or other similar substances specifically manufactured for nonintravenous injection by means of hypodermic needles.

1. Except as restricted by paragraph (C) of this rule, an acupuncturist with an active license may practice injection therapy in the treatment of patients in his or her care

1. Requirements to Practice Injection Therapy. The acupuncturist shall:
2. possess a Colorado acupuncture license in good standing;
3. hold a current Clean Needle Technique Certificate through the NCCAOM (or successor organization); and
4. be current in basic life support (BLS) or cardiopulmonary resuscitation (CPR) approved by the American Heart Association or American Red Cross;
5. complete educational coursework covered in subsection D.

1. Acupuncturists employing injection therapy shall use only those substances and techniques for which they have received training. Required Educational Coursework shall include:
2. Anatomy and Physiology
3. Acupuncture physical exam and differential diagnosis;
4. Acupuncture point location, including underlying anatomy;
5. Acupuncture needling technique;
6. General injection safety;
7. Acupuncture point injection therapy;
8. Pharmacology; and
9. Clean Needle Technique.
10. For the use of injectable substances prepared from oriental herbs, completion of training in Chinese herbology and injection of Chinese herbal injectables is required.

To demonstrate satisfying the training requirements in Chinese herbology and injection of Chinese herbal injectables the Director will accept NCCAOM, or a successor organization’s, certification in Chinese herbology and/or certification in Oriental Medicine.

10. For the use of substances listed in (E)(3)(a)(12-17), instruction on the use of inhaled O2 and IM epinephrine for emergency use is required.

1. Permissible Substances
2. An acupuncturist shall comply with all federal and state laws that pertain to obtaining, possessing and administering any drug;
3. A substance shall only be approved for use if procured in compliance with all federal and state laws;
4. The following drugs are authorized in the modes of administration that are specified except as limited or restricted by federal or state law:
5. Permissible substances that an acupuncturist may obtain for injection therapy as

permitted per Section 12-29.5-102(3.3), C.R.S and as permitted by the

Director per Section 12-29.5-102(3), C.R.S. are:

(1) Dextrose;

(2) d-glucose;

(3) Enzymes except urokinase;

(4) Glucose;

(4) Homeopathic Substances (to only include those that are within the US

Pharmacopia);

(5) Hyaluronic Acid;

(6) Minerals;

(7) Saline;

(8) Sarapin;

(9) Sodium chloride;

(9) Sterile water;

(10) Traumeel;

(11) Vitamins;

(12) Cyanocobalamin;

(13) Lidocaine;

(14) Marcaine (Bupivacaine Hydrochloride) with or without epinephrine;

(15) Oriental Herbs

(16) Procaine ; and

(17) Vitamin B-12.

1. Patient safety.
2. Acupuncturists shall have an adverse event/emergency plan in place.
3. An acupuncturist practicing injection therapy of substances listed in (E)(3)(a)(12)-(17) shall be equipped and trained to treat patients with oxygen and epinephrine. The oxygen and emergency epinephrine kit shall be on site where injection therapy utilizing substances with potential allergic side effects are being rendered.
4. An acupuncturist authorized to practice injection therapy shall not inject any substance intravenously.

1. Acupuncturists shall show current medical malpractice coverage for this procedure and maintain coverage.
2. It is the acupuncturist’s responsibility to only inject substances that are listed in subsection

E and are explicitly covered by the acupuncturist’s insurance policy obtained in

compliance with Section 12-29.5-104(6), C.R.S.

Relicense Education Requirements

Colorado Department of Regulatory Agencies

https://www.colorado.gov/pacific/dora/boards_programs

Florida PIT SCOPE

Specific Authority 457.102(1), 457.104 FS. Law Implemented

457.102(1) FS. History–New 11-6- 01. 64B1-4.012 Acupoint

Injection Therapies. Effective March 1, 2002, adjunctive therapies

shall include acupoint injection therapy which shall mean the

injection of herbs, homeopathics, and other nutritional

supplements in the form of sterile substances into acupuncture

points by means of hypodermic needles but not intravenous

therapy to promote, maintain, and restore health; for pain

management and palliative care; for acupuncture anesthesia; and

to prevent disease. Specific Authority 457.102, 457.104 FS. Law

Implemented 457.102 FS. History–New 2-18-01.

New Mexico has two levels of scope of practice. Expanded Practice practitioners can inject

16.2.2.8 SCOPE OF PRACTICE: Pursuant to Section 61-14A-3 NMSA

1978, the practice of oriental medicine in New Mexico is a distinct system of primary

health care with the goal of prevention, cure, or correction of any disease, illness,

injury, pain or other physical or mental condition by controlling and regulating the flow

and balance of energy, form and function to restore and maintain health. Oriental

medicine includes all traditional and modern diagnostic, prescriptive and therapeutic

methods utilized by practitioners of acupuncture and oriental medicine. The scope of

practice of doctors of oriental medicine shall include but is not limited to:

A. evaluation, management and treatment services;

B. diagnostic examination, testing and procedures;

C. the ordering of diagnostic imaging procedures and laboratory or

other diagnostic tests;

D. the surgical procedures of acupuncture and other related

procedures;

E. the stimulation of points, areas of the body or substances in the

body using qi, needles, heat, cold, color, light, infrared and ultraviolet, lasers, sound,

vibration, pressure, magnetism, electricity, electromagnetic energy, bleeding, suction,

or other devices or means;

F. physical medicine modalities, procedures and devices;

G. therapeutic exercises, qi exercises, breathing techniques,

meditation, and the use of biofeedback devices and other devices that utilize heat, cold,

color, light, infrared and ultraviolet, lasers, sound, vibration, pressure, magnetism,

electricity, electromagnetic energy and other means therapeutically;

H. dietary and nutritional counseling and the prescription or

administration of food, beverages and dietary supplements therapeutically;

I. counseling and education regarding physical, emotional and

spiritual balance in lifestyle;

J. prescribing, administering, combining, providing, compounding

and dispensing any non-injectable herbal medicine, homeopathic medicines, vitamins,

minerals, enzymes, glandular products, natural substances, protomorphogens, live cell

products, amino acids, dietary and nutritional supplements; cosmetics as they are

defined in the New Mexico Drug, Device and Cosmetic Act and nonprescription drugs

as they are defined in the Pharmacy Act;

K. the prescription or administration of devices, restricted devices and

prescription devices as defined in the New Mexico Drug, Device and Cosmetic Act

(Section 26-1-1 NMSA 1978) by a doctor of oriental medicine who meets the

requirements of 16.2.2.9 NMAC.

[16.2.2.8 NMAC – Rp, 16.2.2.8 NMAC, 02-15-05; A, 11-28-09]

16.2.2.9 DEVICES, RESTRICTED DEVICES AND PRESCRIPTION

DEVICES: The board determines that devices, restricted devices and prescription

devices as defined in the New Mexico Drug, Device and Cosmetic Act (Section 26-1-1

NMSA 1978) are necessary in the practice of oriental medicine. Doctors of oriental

medicine who have the training recommended by the manufacturer of the device shall

be authorized to prescribe, administer or dispense the device.

[16.2.2.9 NMAC – Rp, 16.2.2.9 NMAC, 02-15-05; A, 11-28-09]

16.2.2.10 SCOPE OF PRACTICE FOR EXPANDED PRACTICE:

A. In addition to the scope of practice for a licensed New Mexico

doctor of oriental medicine, the scope of practice for those certified in expanded

practice shall include certification in any or all of the following modules: basic

injection therapy, injection therapy, intravenous therapy and bioidentical hormone

therapy. practitioners previously certified as Rx1 extended prescriptive authority, will

be certified for basic injection therapy and practitioners previously certified as Rx2

expanded prescriptive authority, will be certified for injection therapy, intravenous

therapy and bioidentical hormone therapy.

B. The expanded practice shall include:

(1) the prescribing, administering, compounding and dispensing of

herbal medicines, homeopathic medicines, vitamins, minerals, amino acids, proteins,

enzymes, carbohydrates, lipids, glandular products, natural substances, natural

medicines, protomorphogens, live cell products, gerovital, dietary and nutritional

supplements, cosmetics as they are defined in the New Mexico Drug, Device and

Cosmetic Act (26-1-1 NMSA 1978) and nonprescription drugs as they are defined in

the Pharmacy Act (61-11-1 NMSA 1978); and

(2) the prescribing, administering, compounding and dispensing of the

following dangerous drugs or controlled substances as they are defined in the New

Mexico Drug, Device and Cosmetic Act, the Controlled Substances Act (30-31-1

NMSA 1978) or the Pharmacy Act:

(a) sterile water;

(b) sterile saline;

(c) sarapin or its generic;

(d) caffeine;

(e) procaine;

(f) oxygen;

(g) epinephrine;

(h) vapocoolants;

(i) bioidentical hormones; and

(j) biological products, including therapeutic serum.

C. When compounding drugs for their patients, doctors of oriental

medicine certified for expanded practice and prescriptive authority shall comply with

the compounding requirements for licensed health care professionals in the United

States pharmacopeia and national formulary.

[16.2.2.10 NMAC – N, 02-15-05; A, 11-28-09]

16.2.2.11 [RESERVED][16.2.2.11 NMAC – Rp 16.2.2.10 NMAC, 02-15-05; Repealed, 11-28-09]

16.2.2.12 PRESCRIPTION PADS: A doctor of oriental medicine, when

prescribing, shall use prescription pads imprinted with his name, address, telephone

number and license number. If a doctor of oriental medicine is using a prescription pad

printed with the names of more than one doctor of oriental medicine, each doctor of

oriental medicine shall have a separate signature line indicating the name and license

number. Each specific prescription shall indicate the name of the doctor of oriental

medicine for that prescription.

[16.2.2.12 NMAC – Rp 16.2.2.11 NMAC, 02-15-05; A, 11-28-09]

cid:5516EE5C-D2DF-40E4-9022-59CA3DF4C91F

http://www.pointinjection.com/ht/sc.ait.regs.pdf

SOUTH CAROLOINA – law as it relates to PIT

Acupuncture Act of South Carolina

Article 6 Section 40-47

Any sterile medicinal liquid:

Herbal injectables

Western medicinal injections

Homeopathics

Nutritionals

Normal saline

Vitamins

Any sterile medicinal liquid which can be used for intramuscular injection is suitable for acupuncture injection therapy. Commonly used sterile Herbal Injectables:Gan Cao (Glycyrrhizae), Dan Shen (Salvia), Ai Ye (Fo. Artemisiae Argyi), Western Medicinal Injections, Homeopathics, Nutritionals, Normal saline, Vitamins.

EDUCATION REQUIREMENTS

60 hour course.

UTAH Law and education regarding PIT
Statute
https://le.utah.gov/xcode/Title58/Chapter72/58-72-S102.html?v=C58-72-S102_1800010118000101 

R156. Commerce, Occupational and Professional Licensing. R156-72. Acupuncture Licensing Act Rule.
R156-72-101. Title.
This rule is known as the “Acupuncture Licensing Act Rule”.
R156-72-102. Definitions.
In addition to the definitions in Title 58, Chapter 1, Division of Occupational and Professional Licensing Act, and Title 58, Chapter 72, Acupuncture Licensing Act, the following rule definitions supplement the statutory definitions:
(1) “ACAOM” means the Accreditation Commission for Acupuncture and Oriental Medicine.
(2) “According to practitioner training” in Subsection 58-72-102(5)(b)(ii) means that the licensee has completed education and training from an educational program accredited or recognized by ACAOM regarding the recommendation, administration, or provision of dietary guidelines, herbs, supplements, homeopathics, and therapeutic exercise.
(3) “Administration” in Subsection 58-72-102(5)(b)(ii) means the direct application of an herb, homeopathic, or supplement to the body of a patient by:
(a) ingestion;
(b) topical application;
(c) inhalation; or
(d) point injection therapy (PIT).
(4) “Herbs” and “homeopathics” in Subsection 58-72-102(5)(b)(ii) may include:
(a) vitamins;
(b) minerals;
(c) amino acids;
(d) proteins; and
(e) enzymes.
(5) “Insertion of acupuncture needles” in Subsection 58-72-102(5)(a) means a procedure of acupuncture and oriental
medicine including myofascial trigger point therapy, intramuscular therapy, perineural injection therapy (PIT), prolotherapy, proprioceptive stimulation, Ashi points, or dry needling techniques.
(6) “Modern research” in Subsection 58-72-102(5)(b)(ii) means practicing according to acupuncture and oriental medicine education and training as recognized through NCCAOM.
(7) “NCCAOM” means the National Commission for the Certification of Acupuncture and Oriental Medicine, formerly known as the National Commission for the Certification of Acupuncturists (NCCA).
R156-72-103. Authority – Purpose.
This rule is adopted by the Division under the authority of Subsection 58-1-106(1)(a) to enable the Division to administer Title 58, Chapter 72.
R156-72-104. Organization – Relationship to Rule R156-1.
The organization of this rule and its relationship to Rule R156-1 is as described in Section R156-1-107.
R156-72-302a. Qualifications for Licensure – Certification and Exam Requirements.
In accordance with Subsections 58-72-302(3) and (4), to meet the requirements for current active certification in acupuncture under guidelines established by NCCAOM, and the requirements for passing the examination required by the Division, an applicant for licensure as a licensed acupuncturist shall submit documentation of:
(1) current and active NCCAOM certification; or
(2) pursuant to Subsection 58-1-302(1), licensure in good standing as an acupuncturist in any state, district, or territory of the United States, for at least one year immediately preceding the application.
R156-72-302b. Qualifications for Licensure – Animal Acupuncture.
In accordance with Subsections 58-28-307(12)(d) and 58-72-102(5)(b)(iii), to engage in the practice of animal acupuncture, a licensed acupuncturist shall complete 100 hours of animal acupuncture training and education that includes:
(1) fifty hours of on the job training under the indirect supervision of a licensed veterinarian; (2) animal anatomy training; and
(3) the remaining hours in animal specific continuing education.
R156-72-302c. Informed Consent.
(1) In accordance with Subsection 58-72-302(5), to enable patients to give informed consent to treatment, a licensed acupuncturist shall have a patient chart for each patient that includes:
(a) a written review of symptoms;
(b) a statement signed by the patient consenting to acupuncture treatment; and
(c) if the patient is receiving an adjunctive therapy as defined in Subsection 58-72-102(5), a written disclosure signed by
the patient regarding the licensed acupuncturist’s education and training to perform that therapy.

(2) In accordance with Section 58-72-503, patient records, including records documenting informed consent, shall be maintained for seven years.
R156-72-303. Renewal Cycle – Procedures.
(1) In accordance with Subsection 58-1-308(1), the renewal date for the two-year renewal cycle applicable to licensees under Title 58, Chapter 72, Acupuncture Licensing Act, is established by rule in Section R156-1-308a.
(2) Renewal procedures shall be in accordance with Sections R156-1-308b through R156-1-308l.
(3) In accordance with Subsections 58-1-308(3)(b) and 58-72-303(3), a licensee who does not maintain current and active NCCAOM certification shall:
(a) complete at least 30 continuing education units (CEU) or 30 professional didactic activity (PDA) points within the two-year renewal period; and
(b) maintain current BLS-CPR certification.
R156-72-503. Unprofessional Conduct.
In accordance with Subsection 58-72-102(6), “unprofessional conduct” includes:
(1) failing to maintain office, instruments, equipment, appliances, or supplies in a safe and sanitary condition;
(2) violating Subsection 58-72-303(3) regarding renewal qualifications by:
(a) failing to maintain current and active NCCAOM certification;
(b) failing to complete all CEUs required under Subsection R156-72-303(3); or
(c) failing to maintain current BLS-CPR certification;
(3) failing to abide by the NCCAOM Code of Ethics revised January 1, 2016, that is hereby incorporated by reference; (4) failing to maintain patient records for a seven-year period;
(5) recommending, administering, or providing dietary guidelines, herbs, supplements, homeopathics, or therapeutic
exercise without having completed the required practitioner training pursuant to Subsection 58-72-102(5)(b)(ii) and Subsection R156-72-102(2); or
(6) administering venous injections, immunizations, or controlled substances.
KEY: acupuncture, licensing
Date of Last Change: March 25, 2021
Notice of Continuation: September 7, 2021
Authorizing, and Implemented or Interpreted Law: 58-72-101; 58-1-106(1)(a); 58-1-202(1)(a)

Affected by 63I-1-258 on 7/1/2021

RCW 18.06.010

(1)(m) Point injection therapy, as defined in rule by the department. Point injection therapy includes injection of substances, limited to saline, sterile water, herbs, minerals, vitamins in liquid form, and homeopathic and nutritional substances, consistent with the practice of acupuncture or Eastern medicine. Point injection therapy also includes injection of local anesthetics, such as lidocaine and procaine, for reduction of pain during point injection therapy, consistent with the practice of acupuncture and Eastern medicine and training requirements as defined in rule. An acupuncturist or acupuncture and Eastern medicine practitioner using point injection therapy who has met the training and education requirements established pursuant to RCW 18.06.230 may use oxygen, and epinephrine for potential emergency purposes, such as an allergic or adverse reaction, for patient care and safety. Point injection therapy does not include injection of controlled substances contained in Schedules I through V of the uniform controlled substances act, chapter 69.50 RCW or steroids as defined in RCW 69.41.300;