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Pain Management And Prescribing Controlled Drugs. Timothy J. Benedict, RPh Assistant Executive Director Ohio State Board of Pharmacy tim.benedict@bop.ohio.gov 614-466-4143. Legal Aspects Of Prescribing. What is the problem ? What constitutes legitimate practice?
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Pain Management And Prescribing Controlled Drugs • Timothy J. Benedict, RPh • Assistant Executive Director • Ohio State Board of Pharmacy • tim.benedict@bop.ohio.gov • 614-466-4143
Legal Aspects Of Prescribing • What is the problem ? • What constitutes legitimate practice? • How can I avoid problems in my practice
What Is The Problem? • EDUCATION • Tolerance • Addiction
Lack of Education Leads to: • Desire to avoid the patient/Rx • “Just say no” attitude • Blame law enforcement for hesitation in treating/prescribing
Factors For Determining A Schedule • Actual or relative potential for abuse • Scientific evidence of the drug’s pharmacologic effects • State of current scientific knowledge regarding the substance • Its history and pattern of abuse
Factors (continued) • The scope, duration, and significance of abuse • What, if any, risk there is to the public health • The drugs “psychic” or physiologic dependence liability • Whether a substance is an immediate precursor of a substance already controlled
What Constitutes Legitimate Practice? Ohio Administrative Code Rule 4729-5-30(A) • Physician/pharmacist responsibility
What Constitutes Legitimate Practice? Ohio Revised Code - 4731.22(B) • 4731.22(B)(2) • 4731.22(B)(3) • 4731.22(B)(6)
What Constitutes Legitimate Practice? Ohio Revised Code – 2925.03 • 2925.03(A) • 2925.03(B)
What Constitutes Legitimate Practice? Ohio Administrative Code – 4731-21-02 • Physician Requirements
How Can I Avoid Problems in My Practice? • Understand the requirements for proper prescribing • Communication – most important • Documentation • Drug Therapy – is it appropriate?
Case Review • No Individualized Treatment • Duplication of Therapy • Pain Management Physician seeing 50-70 patients daily • Logistics – patient/prescriber/pharmacy
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
OARRS • Registration at www.ohiopmp.gov • Obtain up to 2 years of Rx history • Average time to obtain report is 15 seconds