Transcript Pain Management And Prescribing Controlled Drugs

Pain Management And
Prescribing Controlled Drugs
• Timothy J. Benedict, RPh
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Assistant Executive Director
Ohio State Board of Pharmacy
[email protected]
614-466-4143
Legal Aspects Of Prescribing
• What is the problem?
• What constitutes legitimate practice?
• How can I avoid problems in my practice
What Is The Problem?
• EDUCATION
– Tolerance
– Addiction
Lack of
Education Leads to:
• Desire to avoid the patient/Rx
• “Just say no” attitude
• Blame law enforcement for hesitation in
treating/prescribing
• WHAT CONSTITUTES LEGITIMATE
PRACTICE?
Factors For Determining A
Schedule
1. Actual or relative potential for abuse
2. Scientific evidence of the drug’s
pharmacologic effects
3. State of current scientific knowledge
regarding the substance
4. Its history and pattern of abuse
Factors (continued)
5. The scope, duration, and significance of abuse
6. What, if any, risk there is to the public health
7. The drugs “psychic” or physiologic dependence
liability
8. Whether a substance is an immediate precursor
of a substance already controlled
What Constitutes Legitimate
Practice?
Ohio Administrative Code Rule
4729-5-30(A)
• Physician/pharmacist responsibility
What Constitutes Legitimate
Practice?
Ohio Revised Code - 4731.22(B)
• 4731.22(B)(2)
• 4731.22(B)(3)
• 4731.22(B)(6)
What Constitutes Legitimate
Practice?
Ohio Revised Code – 2925.03
• 2925.03(A)
• 2925.03(B)
What Constitutes Legitimate
Practice?
Ohio Administrative Code – 4731-21-02
• Physician Requirements
How Can I Avoid Problems in
My Practice?
• Understand the requirements for proper
prescribing
• Communication – most important
• Documentation
• Drug Therapy – is it appropriate?
Case Review
• No Individualized Treatment
• Duplication of Therapy
• Pain Management Physician seeing 50-70
patients daily
• Logistics – patient/prescriber/pharmacy
Case Review
• Unclear Diagnosis – back pain
• Patient determines what is appropriate
• Ignoring problems
– Drugs in Toilet
– Complaints from family about drug abuse
– Patient refusal for other treatment/diagnostic
procedures – just wants drugs
OARRS
• Registration at www.ohiopmp.gov
• Obtain up to 2 years of Rx history
• Average time to obtain report is 15 seconds