1. Pain Management And Prescribing Controlled Drugs Timothy J. Benedict, RPh Assistant Executive Director Ohio State Board of Pharmacy tim.benedict@bop.ohio.gov 614-466-4143

2. Legal Aspects Of Prescribing What is the problem? What constitutes legitimate practice? How can I avoid problems in my practice

3. What Is The Problem? EDUCATION –Tolerance –Addiction

4. Lack of Education Leads to: Desire to avoid the patient/Rx “Just say no” attitude Blame law enforcement for hesitation in treating/prescribing

5. WHAT CONSTITUTES LEGITIMATE PRACTICE?

6. Factors For Determining A Schedule 1.Actual or relative potential for abuse 2.Scientific evidence of the drug’s pharmacologic effects 3.State of current scientific knowledge regarding the substance 4.Its history and pattern of abuse

7. Factors (continued) 5.The scope, duration, and significance of abuse 6.What, if any, risk there is to the public health 7.The drugs “psychic” or physiologic dependence liability 8.Whether a substance is an immediate precursor of a substance already controlled

8. What Constitutes Legitimate Practice? Ohio Administrative Code Rule 4729-5-30(A) Physician/pharmacist responsibility

9. What Constitutes Legitimate Practice? Ohio Revised Code - 4731.22(B) 4731.22(B)(2) 4731.22(B)(3) 4731.22(B)(6)

10. What Constitutes Legitimate Practice? Ohio Revised Code – 2925.03 2925.03(A) 2925.03(B)

11. What Constitutes Legitimate Practice? Ohio Administrative Code – 4731-21-02 Physician Requirements

12. How Can I Avoid Problems in My Practice? Understand the requirements for proper prescribing Communication – most important Documentation Drug Therapy – is it appropriate?

13. Case Review No Individualized Treatment Duplication of Therapy Pain Management Physician seeing 50-70 patients daily Logistics – patient/prescriber/pharmacy

14. Case Review Unclear Diagnosis – back pain Patient determines what is appropriate Ignoring problems –Drugs in Toilet –Complaints from family about drug abuse –Patient refusal for other treatment/diagnostic procedures – just wants drugs

15. OARRS Registration at www.ohiopmp.govwww.ohiopmp.gov Obtain up to 2 years of Rx history Average time to obtain report is 15 seconds