You wouldn’t believe all of the precautions I have to take in order to prescribe opiates to patients with chronic pain. The over-riding concern I have is maintaining my license and DEA number. Therefore, I do urine drug testing on each visit, frequently check the state court site for drug crimes, check the state database for doctor shoppers, and have patients sign paperwork holding me harmless for side effects/death. On each visit, patients must sign that they are not under investigation for drug and drug related crimes, and that they have not gone to another doctor for narcotics for chronic pain. I have camera surveillance for the public areas (we have observed non-patient individuals asking patients about their prescriptions in the office) and an armed security guard (very helpful for discharges).
I order to stay in practice, because of the DEA, I must consider that any patient could become an informant for the DEA. I must also profile new patients to determine whether they could an agent on a sting.
We have had patients bringing in urine in condoms, or trying to get their child to produce urine for them in the bathroom. We have had tandem teams come in with one person going to the bathroom and leaving urine for the patient who comes in next. We have patients shaving in opioid to test positive on the rapid screen to prove that they are taking the medications. We have had a patient use their cell phone to record activity in the clinic. (this patient told me this, so we don’t allow cell phones in the exam rooms) Nothing surprises me now.
Thank you for sharing your experience - scary, but I believe every word of it.
Doctors are forced to put the government threat over the treatment and well being of the patient... and it’s only going to get worse.