Opioid Prescriptions:

What Patients Need to Know

As many are no doubt already aware, there have been substantial changes in Maine law governing the prescription of opioid (narcotic) drugs.  Many of our patients are still struggling with why these changes have happened and what some of the details of the law mean to them.  Dr. Thomas Macharia, the medical director over TAMC’s primary care practices, helps break it down.
 
(left) Dr. Thomas Macharia, Family Practice and Internal Medicine

Why did the law change?

While opioids have been common pain medications, they are strong drugs that can be highly addictive. In fact, up to one in four people who take opioids long term become addicted.  These drugs have been overprescribed in the past.  With the opioid epidemic sweeping through our state and country, significant changes are being made in both when and how these drugs are prescribed.
 
What can I do for pain?
Opioids are not the best way to treat long-term or chronic pain that is not related to active cancer, such as arthritis or low back pain. They cause way more harm without significant long term benefit.  However, they can help if you have short-term acute pain, such as after surgery for a broken bone or in managing pain associated with cancer.
 
Other treatments may work better and have few risks, including: non-drug treatments, such as exercise, physical therapy, spinal manipulation, massage therapy, and acupuncture; over-the-counter medicines; injections, such as steroids; and other prescription drugs.  Talk to your provider about what the best option may be for you.  Several patients who have successfully come off opioids for chronic pain report better functioning and even less chronic paint.
 
What if I really do need an opioid prescription?
If you are prescribed a narcotic, please be aware that there are many changes now in place that are mandated by state law. All providers and pharmacists must follow these regulations, which are intended to help prevent opiate abuse.
 
While there are many rules and requirements established under LD 1646, “An Act to Prevent Opiate Abuse by Strengthening the Controlled Substances Prescription Monitoring Program,” here are some key points our patients should know:
 
  • There are dosage limits (in most cases, no more than 100 MME/day).
  • You are not allowed early refills.
  • You are not allowed to have prescriptions from multiple providers.
  • Your provider will review your controlled substance drug history from a secure online database prior to prescribing.
  • You may be called at random for a pill count or a urine drug screen.  If you fail to comply within 24 hours, you jeopardize your prescription.
  • If you are going to be on a prescribed controlled substance for more than 90 days, you must sign a medication contract that is to be renewed annually AND when your prescription has changed or you have changed pharmacies. This contract will be part of your medical record.
  • In addition to regular monitoring, you will be reevaluated by your provider periodically to see if the medication is having any benefit and any harm.
 
Your provider will talk about the risks and benefits of any medications prescribed to you.  Please talk to your provider if you have questions or concerns.
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