1.
Initial Patient Evaluation- No controlled substances will be prescribed
on the patientís first visit to the Pain Clinic. By law and by the State’s
Board of Medical Examiners, we are required to gather a comprehensive
medication history before beginning the prescription of these substances. It is
also our policy not to write prescriptions for controlled substances, before
the Narcotic contract is signed. The law requires that there be a
patient-physician relationship established before treatment is undertaken.
Prescriptions will not be written for any non-patients.
2.
Controlled Substance Agreement- This Agreement must be read and signed
before any prescription medications are to be dispensed. It contains important
information pertinent to the use of these substances.
3.
Telephone Calls- No prescriptions will be “refilled”
or “called in” to any pharmacies over
the phone. Also no prescriptions will be faxed. In addition, no medication
changes will be made over the telephone. This policy applies to refilling
prescriptions and starting new medications.
4.
After Business Hours, Holidays, and Weekends-
No prescriptions will be
written at these times. Prescriptions will be written only during regular
business hours. Therefore, it is the patientís responsibility to keep track of
his/her medications in order not to run out of them during those times.
Business hours are:
Monday - Thursday from 8:00AM until 3:00PM.
Fridays from 8:00AM until Noon.
5.
Drug Screening Test and Follow-up - By law and by the State’s Board of Medical
Examiners, we are required to maintain adequate documentation with regards to
our patientís use of controlled substances. Therefore, you may be required to
provide urine or blood samples for the purpose of drug screening tests. It is
unethical and illegal to prescribe medications without adequate follow-up.
Therefore, not keeping your regular appointments constitutes a violation
of this follow-up policy, possibly resulting in the discontinuation of the
medication.
6.
Sharing Medications- This is strictly prohibited. Medications are
to be taken only by the patient for which they were intended.
7.
Selling or Distributing- This is strictly prohibited by State and
Federal Law. This is an illegal practice and could carry jail-time.
8.
Lost or Stolen Medications or Prescriptions- Will not be replaced. We do not
accept ìpolice reportsî as proof.
9.
Obtaining Pain Medications from more than one
physician- This practice is
called “Doctor Shopping” and State Law strictly prohibits it. This is an
illegal practice and could carry jail-time.
10.
Obtaining Pain Medications from any other
sources- This is strictly
prohibited. Patients are not to obtain pain medications from friends, family
members, street drug dealers, or internet pharmacies. Doing so is not only
against our medication policy and agreement, but it is also very dangerous.
11.
Picking-up prescriptions without an
appointment- This practice
is not permitted, especially by someone else for whom the medications were not
intended. Patients must attend their appointments in order to be assessed for
the need to continue taking the medication. Prescriptions will only be handed
to the patient for whom they were intended, and only during regular
appointments.
12.
Identification- Patients may be required to produce a
current, valid Photo I.D., before receiving a prescription for a controlled
substance.
13.
Driving or Operating Heavy Machinery- This is strictly prohibited when taking
controlled substances. In certain cases, an evaluation by an Occupational
Therapy Team may be required to determine if the patient could operate such
vehicles.
14.
Handling Firearms or other Weapons- This is strictly prohibited when taking
controlled substances.
15.
Pregnancy or Lactation- It is strictly prohibited to take controlled
substances when pregnant or lactating. Taking controlled substances while pregnant
may cause fetal abnormalities as well as fetal addiction and perinatal
withdrawal syndrome.
16.
Use of Alcohol- This is strictly prohibited when taking
controlled substances. Combining alcohol and pain medications may result in
death.
17.
Illegal Drug use- This is strictly prohibited and may lead to
discharge from the program.
18.
Using suicide as a threat- This will result in immediate
discontinuation of all pain medications and mandatory, possibly involuntary,
institutionalization in an in-patient psychiatric facility.
19.
Suicidal attempts- This is not a
psychiatric-based pain program. Suicidal attempts will result in immediate and
complete discontinuation of all medications with the potential to be used to
harm the patient. Furthermore, the care of the patient will be transferred to a
psychiatric-based pain program.
20.
Unused Portion of Prescription- Prescription medications should be taken to
all of the Pain Clinic’s appointments for the purpose of drug counts.
Discontinued medications should also be taken to your appointments for the
purpose of being discarded with adequate documentation and in front of
witnesses. A sample may be sent out for analysis and identification. We will
not accept video recordings as proof of disposal.
21.
Medication Prescriptions- Will be issued only in the clinic, during
regular business hours. Nothing will be called in, faxed, or mailed. This is
done for the purpose of maintaining adequate control and documentation on the
distribution of these controlled substances.
22.
Mail-in Prescriptions Services and Medication
Assistance Programs- We cannot be responsible for the handling of your
prescriptions or your medications by a third party. When using either one of
these medication services, be advised that we are not responsible for problems
that you may run into when using them. If your prescriptions or medications are lost in the mail, or there is
any delay in the shipments, we will not be issuing additional prescriptions ìto
keep you until the medicines arriveî. Also, we will not be “calling them for
you”, to speed up the process, or to see what is happening. In addition, there
are “Mail-in Prescription Services” that require that a prescription for a 90
day supply be written, instead of one with refills. We believe this to be inappropriate
and unsafe, when dealing with controlled substances. Because of this, we will
not be writing for such prescriptions. In general, we do not believe ìMail-in
Prescription Service Programsî to be appropriate for ìControlled Substancesî.
If a medication is lost in the mail, we will not be replacing it. We do not
accept “U.S. Postal Service Mail
loss/rifling report” as proof of loss.
23.
Multiple Pharmacies- This is not
permitted. Patients most agree to use only one pharmacy to obtain their
pain medication. This pharmacy will be of the patientís own choosing. The
patient is responsible for providing us with the name, location and telephone
number of the pharmacy of choice. If for whatever reason the patient decides to
change pharmacies, this is permitted, but the patient must immediately provide
us with the name, location and telephone number of the new pharmacy.
24.
Sharing and obtaining information- The patient must agree to allow his/her pain
physician to share and/or obtain medication related information with/from
his/her other treating physicians. This is essential if medication interactions
are to be avoided. The patient also agrees to allow the pain physician to
freely discuss his/her case with any other physician currently or previously
involved in the patientís care.
25.
Nerve Medicine- Will not be prescribed by our
program. The patient understands that our pain program will not be prescribing
medications for the “Nerves”. Specifically, benzodiazepines such as Valium
(diazepam), Xanax (alprazolam), or Ativan (lorazepam). If the patient is
currently taking these medications, they must continue to be prescribed by the
physician that initiated the therapy, or a licensed psychiatrist.
26.
Recommended Care for your medicines:
a.
Always
bring your medications to your appointments.
b.
Keep all
of your medications away from children. It is best to keep them under lock and
key, even if the patient lives alone.
c.
Always
open your bottles over a counter or table, so that if they fall out you may be
able to collect and use them. Never open the bottle over the commode. We will
not replace damaged medications.
d.
Do not
discuss with others about the types of medicines that you take. There is an
ongoing scam, where certain elements of our society look for people willing to
make this information available, most commonly in pharmacies or even the
waiting room of a pain practice. The unsuspecting patient is then either
assaulted and the medications taken, or followed home, where they patiently
wait for an opportunity to break in and steal the medications.
e.
Never
carry more medicine that what you will consume during that day. If your
medication is lost or stolen, you will be out of it for only one day. Remember,
we will not replace lost or stolen medications.
f.
Always
keep your medications under lock and key, even if you live alone. We have had
cases of visiting friends who may come with someone else, unknown to the owner
of the house, who have stolen the medications on an innocent trip to the
bathroom.
g.
Always
know how much medicine you have left and if you need a refill. It is your
responsibility to know when you are running out of medicine. Adopt an “Early
Warning System” - We recommend that you put aside, in a separate
(well-labeled) container, seven (7) to ten (10) days worth of pain medicine.
Then use the remainder, like you normally would. When the primary supply runs
out, then you know that you have seven (7) to ten (10) days worth of pain
medicine left and that you need to arrange for an appointment to have your
medications refilled.
h.
Never
take more medicine than the allowed amount. If you run out of medicine early,
we will not give you more.
i.
Taking
less medication is perfectly OK, specially if you feel that you do not need as
much.
j.
If you
have a problem with your medication (side-effect), stop taking it immediately.
If the side-effect seems serious, go to your nearest emergency room. If the
side-effect is that you just do not tolerate the medicine, stop it and call our
office staff and request an earlier appointment to discuss the problem. Do not ask to have the medication changed
over the phone, since we will not do so.