Controlled Rxs- fill or refuse?

[mimi06bg]

Hey everyone,

When do you feel it's appropriate for a patient to be on high doses of Norco, oxycodone, lyrica, modafinil and xanax? Considering it's not a cancer patient and the doctor has been disciplined in the past by the medical board for over-prescribing. Would you keep filling these prescriptions? Or how would you go about refusing to fill them? What would you say to that regular customer and doctor? Do you often see people being on 2 short acting opioids?

I'd appreciate your input on this!

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[Chrish]

Why are they on both norco and Oxycodone? I would call dr office and ask for further diagnosis. If you get some generic response like “low back pain”, then tell pt that based on the combination of medications you are on, I don’t fill comfortable filling your prescriptions.”

If it was an e-script and you guys have been filling it before, you can consider filling it for the last time after telling pt so have their scripts sent elsewhere starting next month.

 

[Old Timer]

"the doctor has been disciplined in the past by the medical board for over-prescribing."
The correct response is:
"I can't help you with these." or "I don't feel comfortable filling these prescriptions."

 

[BidingMyTime]

Don't be afraid to say no. While the doc has been disciplined, if s/he is currently allowed to prescribe, then the presumption is s/he has learned from past mistakes, so I wouldn't automatically say no to all of their patients. On the other hand, I would certainly scrutinize their prescriptions more closely than other docs.
And no, there is pretty much no reason anyone would be on 2 short-acting narcs (exception being, maybe tramadol for lesser pain and then norco or oxy for greater pain...even if tramadol technically isn't a narc, I would count it as one.) But Norco and oxy? No, I can't think of any (legitimate) reason why someone would be on both.