Prescribing Painkillers: What the Health Dept. Recommends

Jun 17, 2013

Recently, I reported on Rhode Island's fledgling prescription drug monitoring program (listen to that story here). It's a program that's supposed to spot troubling trends in prescription drug misuse. And as you might know, there's plenty of trouble to spot in Rhode Island, where prescription drug overdose death rates have soared along with rates of addiction to narcotic painkillers.

Despite those troubling statistics, if you're in pain, you might be glad your healthcare provider wants to write you a prescription for a painkiller. You might be glad it's a powerful one, an opioid like OxyContin or Percocet. But because they're so addictive, health department officials believe your provider should take some precautions before handing you such a prescription. Has your prescriber done any of the following? (Adapted from the Rhode Island Department of Health's web site on safe opioid prescribing):

  • Do a full medical exam and take your full medical history
  • Make a treatment plan, including when you might be able to stop taking the medicine
  • Prescribe only the amount you'll need
  • Advise you to take the medicine on a trial basis at first
  • Discuss the risks and benefits of taking opioids, and ask for your informed consent
  • Sign a Prescriber-Patient Agreement, acknowledging you understand the relevant controlled substance laws, the risks of combining opioids with other drugs, and outlining your responsibility for keeping the medication in a secure spot (sample agreement here)
  • Monitor your use of the drug, possibly including pill counts and drug tests
  • Periodically review  your treatment, and suggest other ways of controlling your pain

What else should prescribers do to help curb prescription drug abuse? What about patients' responsibilities? And the government's? I'd love to hear your thoughts.