Furthermore, clinicians can choose from a host of validated screening tools (surveys) that take less than five minutes for a patient to fill out at a clinician’s office.
Explore This IssueJune 2016
If a clinician suspects drug addiction or abuse, urine toxicology screens are very effective, Dr. Katzman added. “You can see if the patient is actually taking the medication as directed and if it is working. If not, you may suspect that the patient took all of the pills early on, or perhaps sold them on the street.
Another way to ascertain whether or not a patient is taking painkillers as prescribed is to perform random pill counts. “Call the patient and request to see them in 24 hours to make sure that they still have the proper number of pills remaining,” Dr. Katzman said. Or, you could request that the patient sign a controlled substance agreement. Although it is not legally binding, the agreement can be educational for the patient and create a partnership between the patient and physician.
On a related note, in an effort to reduce prescription abuse or diversion (i.e., channeling drugs into illegal use), prescribers and pharmacists can employ a prescription drug monitoring program (PDMP). This involves using a state-run electronic search engine to find out if a patient has already been prescribed a controlled substance by another physician. “If a clinician finds this to be the case, this could identify the patient as high risk and alert the clinician to not prescribe additional postoperative medications,” Dr. Katzman said. PDMP is available in all states except Missouri.—KA