1) We abide by ALL state and federal guidelines. If for some reason you are unhappy with this, we recommend you contact your State and Federal representatives.  IT IS THE LAW.
2) No more than 100meq of Morphine per day of any medication. At our discretion we may wean you rapidly depending on the length of time you have been on a medication and the dosing. We may refer you to a detox program instead. If you would like to know how this is calculated there are multiple online dosing calculators or go to vapain.org.
3) Random urine toxicology screens.
4) Random pill counts.
5) History and physical exam at every visit.
6) The Maximum/Strongest Medication we will prescribe except in cases of Cancer, upon referral by an oncologist, or proven gross multiple trauma is Oxycodone 15mg.
7) We do not routinely prescribe Fentanyl, OxyContin, Morphine Sulfate, etc. If this is a problem for you, we recommend you contact your state and Federal representatives and seek help at one of the large teaching hospitals.
8) Unless you have a medically documented allergy to specific classes of medication or a medical contraindication, you will simultaneously be treated with other non-narcotic Medications, PT, independent exercise, yoga, biofeedback, chiropractic, osteopathic manipulation, various injection therapies, etc. Refusal to pursue all forms to treatment is grounds for dismissal. Medication alone is proven to be suboptimal in “relieving“ most pain.
9) We do not treat anxiety or prescribe Xanax.
10) You will be prescribed Narcan (Naloxone), an opioid overdose reversing agent, every year. You are expected to keep it close to you, read instructions and watch YouTube videos on how to use it properly. If you still have questions, ask your pharmacist. Any medication used incorrectly or in excess amounts carries a risk of death and severe permanent bodily injury. You are expected to use your medication only as prescribed. To do otherwise is grounds for immediate dismissal.
11) It is our expectation and your duty to personally read and be very familiar with the package insert on all your medications.
12) You will sign a Pain Contract whether you are receiving an opioid/narcotic medication or not. Please understand that all medications can interfere with your normal function and subject you to a DUI or other legal peril. Drive at your own risk. Operating heavy equipment may not be advised please read the pharmacy package insert.
13) If your medication does not give you at least 50% improvement in your pain and increase your function/quality of life we cannot justify prescribing them to you. If your medications no longer work as well we prefer a medication holiday to reset your body’s tolerance/metabolism of the medication. We do not increase dosing simply because it does not seem to be working. This has been shown to be a failed approach in many instances.
14) You are expected to exercise, socialize, and get out and about. If you are remaining in bed or are basically sedentary, it is bad for your life.
15) ALL medications should be stored in a locked area away from children. Preferably a safe. This is mandatory. We will ask.

16) If ANY PHARMACY performs a pill count and you fail, you will be considered breached from our practice.

Addiction and the resultant destruction of both you and your family is a real threat that we are dedicated to trying to prevent. All that we do is out of concern for you, your family, and the community. If you feel you have a problem please let us know. If you are concerned about medication diversion, i.e. being sold on the streets illegally we urge you to contact your local, state, and federal law enforcement agencies without delay. Only by working together can we quell this emergency while continuing to provide quality, compassionate care to those with an actual need.