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Afraid to prescribe Schedule II narcotics. What can I do to protect my practice and license?

March 7, 2017     

Question:

Hi Jennifer,

With all of the press around addiction to opioids, and investigations into prescribing doctors, I am pretty terrified to prescribe.  If there anything I can do to assuage my fears?  Thoughts?

Thanks, 
Dr. P


Answer: 

I can't say I blame you for being concerned - the government and patients ARE watching. But, that doesn't change the facts - you are the best person to determine, and authorized to determine, whether or not your patients require opioids.  How do you go about it without risking your license, headlines and your career?  We know the answer to that - document document document your "informed" prescribing.  Starts with a proper Opioid Prescribing Policy. Make sure you use your state database (if available to you) to check other prescribers.  Drug test your patients before prescribing. Document your reasons for prescribing, AND definitely document your reasons for NOT prescribing if a patient is requesting.  

Make sure you have compliance in place.  Adopt a policy that details how you comply (in accordance with State guidance) and combat/handle drug seeking patients, and who is authorized to prescribe in your practice and controls you have over theft of prescriptions.   Then, adhere to the policy.  Existing clients get 10% off of our Opioid Prescribing Policy.

Guidance is also available at the state level.  For NY - 

DOH has put out the following  treatment guidelines - https://www.health.ny.gov/professionals/narcotic/opioid_treatment_guidelines/


Connecticut has published a litany of materials on its government site - http://www.ct.gov/dph/cwp/view.asp?a=3137&q=567398

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