Hello,
I was not sure where to post this, but I could use some help, advice, suggestions, etc....please!
I'm a newly practicing pain management specialist. Like many pain management Dr's I am concerned with the growing problem of patients becoming addicted.
To give a little more info on this particular patient I'm currently treating, he has been on narcotics for 3 years. Taking Ms contin 30mg 4x aday for breakthru pain and Duragesic patch which is fentanyl, a extremely powerful narcotic, wearing 2 patches a day for 2 days at strength of 200 mcg. Both drugs are Class II. Two years go by while prescribing, and one day the patient asked to start lowering their dose, which I agreed and to help with the withdrawals I prescribed Suboxone. The next day, patient called complaining, he could not take it anymore because you had to leave the pill under tongue to dissolve and it tasted nasty. He asked if there was any other way to take the pill, I replied no.
The following visit, I asked how he felt. He said fine and didn't mentioned about lowering the dose anymore. I also didn't bring it up. And we went back to prescribing. Since then we have increased the dosage. From some of what I read online, could the fact we tried to lower dose and then did nothing after that, be a sign of patient addiction and thus make me liable for failing to recognize his addiction?
Am I not in a better position being a specialist in narcotics to keep the patient from becoming addicted. Granted my patient is an adult and makes their own decisions, but again am I not the doctor who knows more about this then the patient.
My question: Can I be held Liable/responsible for failure to recognize his addiction, not screening urine for signs of possible abuse and not monitoring his blood levels, liver, kidney for possible damage???
If you feel I'm wrong for causing my patient to become addicted, please tell me.
Thanks,
Rosen
I was not sure where to post this, but I could use some help, advice, suggestions, etc....please!
I'm a newly practicing pain management specialist. Like many pain management Dr's I am concerned with the growing problem of patients becoming addicted.
To give a little more info on this particular patient I'm currently treating, he has been on narcotics for 3 years. Taking Ms contin 30mg 4x aday for breakthru pain and Duragesic patch which is fentanyl, a extremely powerful narcotic, wearing 2 patches a day for 2 days at strength of 200 mcg. Both drugs are Class II. Two years go by while prescribing, and one day the patient asked to start lowering their dose, which I agreed and to help with the withdrawals I prescribed Suboxone. The next day, patient called complaining, he could not take it anymore because you had to leave the pill under tongue to dissolve and it tasted nasty. He asked if there was any other way to take the pill, I replied no.
The following visit, I asked how he felt. He said fine and didn't mentioned about lowering the dose anymore. I also didn't bring it up. And we went back to prescribing. Since then we have increased the dosage. From some of what I read online, could the fact we tried to lower dose and then did nothing after that, be a sign of patient addiction and thus make me liable for failing to recognize his addiction?
Am I not in a better position being a specialist in narcotics to keep the patient from becoming addicted. Granted my patient is an adult and makes their own decisions, but again am I not the doctor who knows more about this then the patient.
My question: Can I be held Liable/responsible for failure to recognize his addiction, not screening urine for signs of possible abuse and not monitoring his blood levels, liver, kidney for possible damage???
If you feel I'm wrong for causing my patient to become addicted, please tell me.
Thanks,
Rosen
