Responsible prescribing practices

July 19, 2019

Nicholas Andrews, MD, PhD, Charlotte Pickett, MD

Pain relief can be life changing for patients with chronic pain, but ob/gyns need to be mindful of how to prescribe medication properly.

Prescribe only in situations where the pain is very likely to improve with time and additional treatments.

For more on treating pain: Making chronic pelvic pain a little less painful

Counsel patients as to risks and signs of tolerance, dependence, and opioid-induced hyperlagesia.

For more on opioids: ‘Policing’ pregnant women during the opioid epidemic

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Counsel regarding safe use, such as avoiding taking during any activity in which sedation would cause risk of harm to self or others and storing safely and securely.

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Clearly definine and document the prescribing relationship (opioid contract).

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Utilize a prescription monitoring database.

Closely montitor for abuse/diversion (dosing adjustments without discussion, lost prescriptions, additional substance abuse).

Consider suboxone in cases of comorbid depression/concern for overdose.

Concurrently consult with a pain specialist.