The tide has turned. When I started it was all about treating the 5th vital sign of pain. Now that hydrocodone can go for $20+ a pill and generate the crime needed for that, our priorities have changed.
To me this is a business strategy to position Walgreen's on the right side of the tracts. This may do more to help Walgreens recruit and retain pharmacists than anything they could do besides double salaries. Do you want to deal with narcotic abusing patients all day long? Make it difficult and let them go to CVS.
We use some kind of pain treatment for just about all our patients, but we refer the "demanding" pain patients to the pain management doctors. We started using a controlled medications agreement for all controlled substances. The primary doctor and pharmacy get a copy. We only give 3 months of Rx for schedule 3-5, and only 1 month for schedule 2 drugs. We will not call in Rxs for controlled meds, they have to have an appointment.
Very inconvenient for the patients I trust.
All of these policies in our office got developed and started last year because the hand writing was on the wall from the government. When California started wanting continuing education in pain management, you knew a change was coming.
