For our patient’s safety and In compliance with Massachusetts law related to opioid prescribing and in response to the January 1, 2013 Massachusetts Medical Use of Marijuana law, Boston Orthopaedic & Spine, LLC has created this policy. Our medical providers evaluate each patient’s situation and carefully develop a plan that considers all available pain relief options, including non-pharmacologic and non-opioid pharmacologic options.
Narcotic and Opiate/Opioid Policy
Our medical providers can not issue a more than 7-day supply opiate prescription to an adult patient for outpatient use for the first time. There are exemptions to this law for adult patients with acute medical conditions such as treatment of chronic pain management, pain associated with a cancer diagnosis or for palliative care. These conditions are generally not applicable to our patients and therefore patients requiring more than a 7-day supply of an opiate prescription will likely be referred to a their primary care physician or a pain management facility for further evaluation. In the event our patient is prescribed an opiate for more than a 7-day supply, the patient’s medical record will state (1) the condition triggering the prescription and (2) that a non-opiate alternative was not appropriate to address the medical condition.
In compliance with Massachusetts law, patients may direct their pharmacist to dispense less Opiate/Opioid pain medication than the full quantity indicated on the prescription. This notation will be included on all Schedule II opioid prescriptions, as required by law. The remaining quantity of the prescription not dispensed per the patient’s discretion is void to any quantity not dispensed.
Narcotics and any other pain medications will NOT be refilled on evenings, holidays, or weekends. Patients must anticipate their medication needs and, if needed, contact the office during regular business hours to request refills of their medication.
Prior to issuing an extended-release long-acting opioid, we are required by law to (1) evaluate the patient’s current condition, risk factors, history of substance abuse, if any, and current medications; and (2) inform the patient and note in the patient’s electronic medical record that the prescribed medication, in the prescriber’s medical opinion, is an appropriate course of treatment based on the medical need of the patient. In the event our medical providers recommend that an extended-release long-acting opioid be utilized during the course of long-term pain management, the prescribing provider and the patient are required to enter into a written pain management treatment agreement which will be included in the patient’s electronic medical record. This agreement will address the benefits as well as the risk factors for abuse or misuse of the prescribed substance.
Effective October 15th, 2016 under the Massachusetts Prescription Monitoring Program all prescribers, before writing a prescription for narcotic drugs, are required to check the patient’s Prescription Monitoring Profile maintained in the Massachusetts Online Prescription Monitoring Program. This database is maintained and operated by the Massachusetts Department of Public Health (DPH).
Effective December 1st, 2016, The Department of Public Health (DPH) established a voluntary non-opiate directive form. This form indicates to all practitioners that the patient shall not be administered or offered a prescription or medication order for an opiate. The patient or their legal guardian may file a voluntary non-opiate directive form with our office which will be included in the patient’s electronic medical record. The patient or their legal guardian may revoke the voluntary non-opiate directive for any reason and may do so at any time, in writing or verbally.
Medical Marijuana Policy
At this time, our medical providers at Boston Orthopaedic & Spine, LLC will not be authorizing medical marijuana due to the lack of efficacy and potential risk to our patients. It is our hope that all patients will acknowledge and respect the decisions of our medical providers regarding the authorization of medical marijuana.