What to do when asked to refill an Rx for opioids for another clinician's patient

Scenario: You work at a multi-provider practice. You are required to refill prescriptions for opioids for chronic pain patients, when other providers are away. Some other providers aren't following the new standards of care for prescribing opioids for chronic, non-cancer pain. You are aware that government drug enforcement agencies are focusing on "pill mills" -- practices that prescribe opioids without medical justification -- and you worry about getting into trouble, because your name is on the prescriptions.

What to do: There are several ways to decrease the risk. One is for each clinician to cover his or her patient refills as much as possible, before the clinician leaves for time off. Another is for clinicians in groups practices to agree on the standards to be followed in the practice and to follow those standards. Another is to contract with patients who are being prescribed opioids so that they agree they will give the office 72 hours notice when they need a refill, to avoid having them come in when their primary provider is off. Finally, if you must prescribe opioids for another clinician's patient, prescribe the smallest amount that will cover the patient until the primary provider returns.

Source: Carolyn Buppert, NP, JD www.buppert.com