Prescribing opiates safely takes a little bit of planning

[fusion_builder_container hundred_percent=”yes” overflow=”visible”][fusion_builder_row][fusion_builder_column type=”1_1″ layout=”1_1″ background_position=”left top” background_color=”” border_size=”” border_color=”” border_style=”solid” spacing=”yes” background_image=”” background_repeat=”no-repeat” padding_top=”” padding_right=”” padding_bottom=”” padding_left=”” margin_top=”0px” margin_bottom=”0px” class=”” id=”” animation_type=”” animation_speed=”0.3″ animation_direction=”left” hide_on_mobile=”no” center_content=”no” min_height=”none” last=”no” hover_type=”none” link=”” border_position=”all”][fusion_text columns=”” column_min_width=”” column_spacing=”” rule_style=”default” rule_size=”” rule_color=”” hide_on_mobile=”small-visibility,medium-visibility,large-visibility” class=”” id=””]

The opioid epidemic is causing tens of thousands of deaths a year in North America, largely due to the diversion of prescription opiates.

When I was practicing as a family doctor, I remember statements made by representatives of these drug companies assuring doctors that addiction could never be caused by prescribing narcotics for legitimate chronic pain. Now we see lawsuits have been launched against pharmaceutical companies associated with these drugs.

Because of these lawsuits, the pendulum has swung the other way in the medical community and I’ve heard of new medical school graduates who refuse to prescribe any narcotic pain-killers no matter what the clinical presentation might be. This is equally as scary.

When I was practicing, I found following guidelines and precautions useful when prescribing opiates for chronic pain. Here are some of the standard steps I used to prevent diversion of opiates:

1) Create an opiate contract signed by the patient detailing grounds for discontinuation of treatment (non-compliance, coming back for early refills, evidence of abuse or trafficking or diversion, etc.)

2) Consultation with a chronic pain specialist

3) Weekly dosettes with close monitoring of limited amounts of dispensed medications. In my opinion, narcotics should almost always be prescribed this way and almost never on a monthly basis

4) Close collaboration with pharmacists is essential; these health professionals are especially invaluable in the early detection of problems with patients. Pharmacists can also set up the weekly dosettes

5) Close monitoring of patients, careful chart documentation of improvements, problems, complications, patient response, improved patient function.

6) Breach of opiate contract stipulations usually requires termination of treatment. Depending on the situation, this may require gradual withdrawal of medication, but if diversion or trafficking is discovered, immediate discontinuation of medication is mandatory.

7) The police may have to be notified if diversion or trafficking is confirmed

.

[/fusion_text][/fusion_builder_column][/fusion_builder_row][/fusion_builder_container]