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Opioid Policies

Controlled substances, such as narcotics, tranquilizers and barbiturates are very useful, but have high potential for misuse.  They are intended to relieve pain specifically to improve function and/or ability to work, not simply to feel good.  Because my physician is prescribing these medications, I agree to the following conditions:

  1. I am responsible for my controlled substance medications.  If the prescription is lost, misplaced or stolen, or if I use it up sooner than prescribed, I understand that it will not be replaced.
  2. I will not request or accept controlled substance medication from any other physician or individual while I am receiving medication from Pain Management Associates Medical Group.
  3. There will be no early refills.  Prescription for refills will be written at my next office visit.  They will not be made if I run out early for any reason including if I lose a prescription or spill/misplace the medication.
  4. I agree to comply with random urine, blood or breath testing to document the proper use of medications.
  5. I understand that if I am told that I am impaired by another person, I will not drive a motor vehicle or operate any other heavy machinery.
  6. I further understand that driving a motor vehicle may not be allowed at times while taking controlled substances.  It is my responsibility to comply with the laws of the state while taking these medications.
  7. I agree to waive any applicable privilege or right of privacy or confidentiality with respect of prescribing my pain medication.
  8. I understand that side effects of sedation, itching, nausea, vomiting, difficulty urinating, constipation and other side effects are possible.  I further understand that a possibility of addiction and the probability of physical dependence exist and I consent to all of these risks.
  9. I understand that suddenly stopping this medication may result in an abstinence syndrome.  I also understand that in addition to the side effects listed above, a possibility of respiratory depression and even death exists from these medications.  If I feel very sleepy, I will not overtake these medications, even of my pain level or other problems are very great.
  10. I understand that violating any of the conditions of this agreement may result in dismissal from this practice.  Violation of this agreement may also result in narcotics no longer being prescribed.
  11. I further agree that my narcotics prescription may be stopped or decreased at any time for any reason by my physician or any other Pain Management Associate physician.