Pain Management And Prescribing Controlled Drugs

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Pain Management And Prescribing Controlled Drugs

• Timothy J. Benedict, RPh
• Assistant Executive Director
• Ohio State Board of Pharmacy
• tim.benedict_at_bop.ohio.gov
• 614-466-4143

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Legal Aspects Of Prescribing

• What is the problem ?
• What constitutes legitimate practice?
• How can I avoid problems in my practice

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What Is The Problem?

• EDUCATION
• Tolerance
• Addiction

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Lack of Education Leads to

• Desire to avoid the patient/Rx
• Just say no attitude
• Blame law enforcement for hesitation in
  treating/prescribing

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• WHAT CONSTITUTES LEGITIMATE PRACTICE?

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Factors For Determining A Schedule

1. Actual or relative potential for abuse
2. Scientific evidence of the drugs pharmacologic
   effects
3. State of current scientific knowledge regarding
   the substance
4. Its history and pattern of abuse

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Factors (continued)

1. The scope, duration, and significance of abuse
2. What, if any, risk there is to the public health
3. The drugs psychic or physiologic dependence
   liability
4. Whether a substance is an immediate precursor of
   a substance already controlled

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What Constitutes Legitimate Practice?

• Ohio Administrative Code Rule
• 4729-5-30(A)
• Physician/pharmacist responsibility

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What Constitutes Legitimate Practice?

• Ohio Revised Code - 4731.22(B)
• 4731.22(B)(2)
• 4731.22(B)(3)
• 4731.22(B)(6)

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What Constitutes Legitimate Practice?

• Ohio Revised Code 2925.03
• 2925.03(A)
• 2925.03(B)

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What Constitutes Legitimate Practice?

• Ohio Administrative Code 4731-21-02
• Physician Requirements

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How Can I Avoid Problems in My Practice?

• Understand the requirements for proper
  prescribing
• Communication most important
• Documentation
• Drug Therapy is it appropriate?

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Case Review

• No Individualized Treatment
• Duplication of Therapy
• Pain Management Physician seeing 50-70 patients
  daily
• Logistics patient/prescriber/pharmacy

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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

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OARRS

• Registration at www.ohiopmp.gov
• Obtain up to 2 years of Rx history
• Average time to obtain report is 15 seconds