Recently new laws were passed in Pennsylvania and other states further regulating the prescriptions our patients receive from our practice. I wanted to use this opportunity to help clear some misconceptions and explain our new office policies as they relate to these changes. We have been and always will be concerned with the growing epidemic of prescription drug use. As a group we feel that the new laws are frightening and impeding interactions with our patients. The doctor-patient relationship is an important aspect of our practice and these new laws limit our ability to have an open discussion regarding pain management. Limiting our ability to care for certain patients in a way we felt was appropriate in some cases and putting undo pressure on patients and their families who may now be afraid to even use pain medication despite their recent surgery.
The laws themselves require that, in addition to our normal history and examination that all patients receiving narcotic or sedative medications be investigated for all prior prescriptions through an online database. Recent or excessive prescription medication usage may result in no prescriptions being issued from our office. In addition to the law our office policy reflects these rising concerns. We do not routinely issue narcotic or sedative medications to patients prior to surgery. As a surgical office we feel comfortable and required to manage your post-operative discomfort. Many studies done on the use of narcotic pain medications point to the long term use of these medications as highly addictive but the short term usage for severe pain control, especially in a surgical situation, does not typically lead to these issues.
The law also requires minors and their guardians to sign consent forms showing the risks, complications and concerns regarding these medications. We feel as a group that all patients should be aware of these risks and will therefore be asking all patients having a surgery to review and sign the consent form if the use of strong pain medications is a possibility. Please keep in mind that signing the form or leaving with the prescription does not require you to take them. The written prescription given to our patients just makes these medications available if needed. Different people will experience different levels of pain after any procedure. Previous law makes it impossible for us to “phone in” these same prescriptions. We still have a level of trust with our patients that they will use these medications only when necessary. As the patient you are ultimately responsible for what goes into your own body.
The spirit of the new legislation is in the right place. We want everyone to be safe and we certainly don’t want to see prescription drug abuse worsen in our community. This is a difficult subject for some people as the pharmaceutical industry has advocated for years to make these medications, which are now so reviled, the treatment of choice for chronic and acute pain management. These new laws will affect the way patients with pain are treated. With a dire shortage in access to dental and medical services for patients across the country it won’t be easy. We encourage people to engage in preventative management to prevent conditions from deteriorating to the point where pain becomes an issue. See your doctor and dentist on a regular basis to prevent small issues from becoming painful ones and we can stop many prescriptions before they are even needed.