Updated Controlled Drug Policy

Updated Controlled Drug Policy

Effective July 1, 2015

Applies to all patients taking controlled drugs on a regular basis, including:

  • Pain medications (excluding Ultram)
  • Stimulant medications (excluding ProVigil and NuVigil)
  • Benzodiazepine anxiety medications (Xanax, Valium, Ativan, Klonapin)

The previous policy will remain intact as written (see below).

Additionally, we will now require regular urine drug testing.  The testing will be done as follows:

  1. Urine drug testing will look for two abnormalities:
    1. Drugs not on patient list show up in the urine test (including illegal drugs).
    2. Drugs on the patient list do not show up in the urine.
  2. Patients at “low risk” will be required to get testing done every 6 months.  “Low risk” patients are those who:
    1. Have been with the practice more than a year without significant incident.
    2. Have never had abnormal urine drug screening.
  3. Patients who are “high risk” will be required to get tested every 3 months.
  4. Children on stimulant medications will be tested once during the school year.
  5. New patients will be tested prior to getting their first prescriptions.
  6. The in-office urine test costs $10 (which must be paid prior to getting prescription filled).
  7. A positive in-office test requires a confirmation test be sent to the laboratory.  There are two ways to pay for this test:
    1. Pay $60 up-front (the cash price for the test).
    2. Apply to insurance and accept billing from the lab (insurance is billed $137)
  8. Patients with unexplained abnormal tests will (at our discretion) either be:
    1. Required to undergo random urine testing over the next year
    2. Dismissed from the practice.
    3. Kept in the practice, but not prescribed any more controlled drugs.

Why are we drug testing?

The main reason we are doing this is to comply with state requirements for the prescription of these medications.  We don’t want to get in trouble with the state.  The second reason is to assure us that our patients are using the medications safely and responsibly.  

How will this work?

We will notify our patients when the test is due.  They must get tested prior to that medication being refilled.  If patients don’t get tested, they don’t get their refill.

Important advice

  • Don’t wait until last minute before getting refills if testing is due.
  • Be honest.  If you’ve not taken your medication, or if you’ve used an illegal drug, TELL US.
  • Understand that we will do our best to be reasonable with this policy.

Our previous controlled drug policy

All of these medications, because of their legal classification, have the following additional rules.  Failing to follow these rules will result (in most circumstances) in discharge from the practice. 

  1. Patients should never share medication with family members or friends.
  2. All patients taking these medications for more than short-term will be required to sign the “Controlled Drug Agreement” for our practice.
  3. Patients should not get medications of this class from other doctors unless it is clearly communicated to us and the other doctor that this has been done.
  4. Patients should not use illegal drugs while taking these medications.
  5. We will not refill these medications early for any reason (even medications lost or stolen are not refilled early).
  6. Refill of these medications will only occur after a person has filled out and submitted the “Controlled Medication Refill Request” form, online or on paper.
  7. All Category 2 drugs require patients to pick up the handwritten prescription in person.  All of these prescriptions can only be written as “Do Not Refill.”  We will only give these prescriptions to patients during regular office hours.
  8. Category 3 and 4 medications can be called in, but refills will only be called in during regular office hours.
  9. Should suspicion arise about the following of these rules, we reserve the right to do drug testing to see:
    1. If the drug is being taken as described
    2. If other drugs are being taken (including illegal) without our knowledge.
    3. We also will, should suspicion arise, check the state controlled drug registry, which records all filled prescriptions of these medications by patients.