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Ways to Recognize and Avoiding Prescription Drug Abuse

With all the media attention on the opioid crisis, now is a good time to recognize and avoid prescription drug abuse in your practice. Along with adhering to your state's prescription drug monitoring program (PDMP) and your state's administrative code, below are four steps you can take now in your office to do your part.

  1. Recognize the signs of abuse and diversion:
    • Signs include:
      • Receiving prescriptions from multiple prescribers
      • Frequently requesting early refills
      • Losing prescriptions
      • Prolonged use
    • Typical behaviors of drug seeking patients include:
      • Requesting maintenance narcotic analgesics
      • Patient calling late in the day, after hours and refusing to go to the ER
      • Patient claiming over-the-counter medications do not alleviate pain
      • Patient refusing to be seen by the provider
      • Patient reporting subjective complaints
  2. Document:
    • Check your state PDMP and include a copy of the report in the patient’s chart with an indication it has been reviewed by the provider (i.e., initial and date it)
    • Note in the patient’s chart why the drug was prescribed along with the strength, dosage and number of pills and the plan
    • Include all discussions with the patient about side effects, informed consent for treatment, drug interactions, etc.
    • Establish an office policy regarding refilling prescriptions 
  3. Communicate:
    • At each visit, review all medications the patient is taking, along with who prescribed them and why
    • When referring a patient to a consultant or specialist for further treatment:
      • Give the patient more than one choice 
      • Offer to make the appointment for the patient
      • Confirm that the patient understands why you are making the referral
  4. Coordinate:
    • Maintain a tracking system for patients who are referred for consultation 
    • Monitor the tracking system for follow-up reports
    • Define the role of each consultant/specialist to ensure a continuity of care

For an excellent resource on identifying a drug abuser in your practice visit https://www.deadiversion.usdoj.gov/pubs/brochures/drugabuser.htm 

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