OUR POLICY ON THE USE OF LONG ACTING NARCOTICS


 

The use of long acting oral and transdermal combination narcotics has become more prevalent over the past several years for the treatment of chronic non-malignant pain. This has lead to the establishment of guidelines developed by the U.S. Department of Health and Human Services for the management of chronic pain. Additionally, there has been recent activity in various state legislatures to develop standardized regulations regarding this important issue.

Pain is one of the most common reasons that patients consult a physician. It is imperative that pain management medications are properly prescribed, taken and monitored in order to achieve maximum benefit. There is the additional risk of addiction. For this reason we feel that it is mandatory that all of our patients who are prescribed long acting narcotics sign a narcotic dispensing agreement.

This agreement addresses several points including the understanding that the patient will not seek narcotic medications from other physicians, will use the medication as prescribed, will use only one pharmacy and will not share or sell the medication. Additionally, the patient must bring empty bottles or pharmacy receipts on each visit.

Violation of this agreement may result in dismissal from our practice and/or legal ramifications.

 

Our Policy With Narcotic Medications
     Through our own clinical experience and the information obtained from research studies, we have developed a treatment program that is designed to utilize treatment modalities such as procedures, physical rehabilitation, and skills training classes to teach you how to cope with your pain. Clinical evidence does not support the effectiveness of taking pain medications every day for an extended period of time in the treatment of your chronic pain. In fact, the opposite is true. The longer the period of time in which the patient has taken daily narcotic and anxiety medications the greater their sensitivity to painful stimuli, and the less responsive they are to effective treatment modalities. Over time, chronic use of pain medications create increased pain ratings, disrupted sleep cycles, anxiety and depression, mood swings, decreased libido, an altered mental status, and a decreased motivation for participating in usual activities. Furthermore, there can be organ damage, which can occur within the stomach, liver and kidneys particularly with medications containing acetaminophen (Tylenol).

     Our goal is to avoid the use of pain medications on a long-term basis and to detoxify patients from their pain medications if these have been used on a daily basis for greater than 6 months. Often we will detoxify patients prior to initiating a treatment plan if we feel the chronic use of these medications would interfere with their response to procedures. We do not automatically assume or prescribe medications when patients see us for their initial evaluation visit. You and your referring physician must understand that any medications that are being prescribed for your pain should continue through the prescribing physician. We may make suggestions or recommendations concerning your medications, but we will not necessarily write your prescriptions.

     If we do prescribe medications temporarily it is your responsibility to make certain you have enough medications to last in between office visits or procedures. We do not phone in medications, especially narcotic medications, at any time during or after business hours or on weekends and holidays. Prescriptions for all your medications must be obtained while you are in the office. Medications must be taken as prescribed, if you take more than the prescribed amount and run out early your prescriptions will not be renewed early. NO EXCEPTIONS. If your medications or prescriptions are lost or stolen these will not be replaced. NO EXCEPTIONS. We perform random urine drug screens on all of our patients. If we prescribe pain medications then you will be asked to sign a narcotic contract with Huntley Pain Specialists. Violation of this contract will forfeit your right to having medications prescribed for your pain.

     Our narcotic policy was developed to provide the patients and our clinicians with guidelines for utilizing narcotic medications in a safe and effective manner; therefore, we adhere strictly to our policy. We do not tolerate medication abuse or misuse, or activities, which are suspicious for diversion of controlled substances. Patients who demonstrate patterns of behavior indicative of this type of abuse or misuse will be discharged from our practice, or, at the least, will no longer receive prescriptions from our practice.