Narcotics Prescription

[Smartybboy]

Hey I recently started in orthopeadics practice. Our practice doesn't prescribe much narcotics, but I was still wondering what would be a high number of prescriptions in a day or a week? For example we are currently prescribing about 1-2 Rx a day. Also when should I be worried about over prescribing the medication? Any help will be appreciated thanks.

[KMD16]

Hard question to answer. None of us here knows the volume of patients to understand or gauge specific number of narcotic expected to be dispense per day, week, month or year. I tell you this. I would ask your SP those questions. In Ortho, every surgeon's preferences varies with respect to pain management. When I did Orthospine. We typical d/c patient from ortho clinic 1 year post op whether they are pain control or not. Pain management or clinic are at your disposal.

[gbrothers98]

The answer to your question is in 2 parts.

 

Does the patient have an acute or chronic need for opiates due to their orthopedic condition?

If acute, then provide them with what they need in a stepwise manner.

Chronic pain is best with a chronic pain provider, refer the patient asap and listen to what the recommendation is.

 

Is there an office or facility opiate policy?

Patients should sign a contract. They should also be given educational materials about opiates. There should be a clear plan in place including how to discontinue opiate therapy without causing too much withdrawal symptoms but treatment for these should be offered also.

 

Take some time to query your state board of medicine. There may be some specific guidelines that you should be following. For instance, in my state of Vermont, chronic opiate treatment needs extensive record keeping including contracts. prior to every opiate prescription for chronic therapy, a query to the state prescription monitoring system is required.

 

Good luck.

George Brothers PA-C 

[KMD16]

^ All are good points. I seriously think the OP should differ this questions to his/her supervising surgeon or practice administrator. Just follow your practice narcotic prescribing protocol. Consider pain management CME.