It would vary by state. In Cali, additional pressure is put on both docs and pharmacies, at different times. (Like when several celebs OD and the media focuses on certain meds.)

Pain docs, are watched the most closely, and in turn can be leerly of prescribing opiates. They see the greatest amount of drug seeking patients...

Certain meds do raise red flags, Oxy is one of them. I didn't like it because it made me feel more intoxicated, but everyone reacts differently. For those that it provides the best pain relief for, they just need to work on maintaining a good relationship with their docs.

I had a pharmacist I really respected, that caught errors over the years, and was kind of a stickler. I'd rather err on the side of caution.

ANYWHOO-you have nothing to worry about. Worst case scenerio they're just checking on compliance, which you are!

No rules regarding this. All docs are different. Best practice is to produce a urine sample if requested, and always honor requests to bring medication bottles to appointments, no matter which doctors asks. This is an easy way to build trust between you and all of your doctors.

I believe everyone else is correct about there not being any hard or fast rules. The state in live in (TN), the abuse of opiates is off the charts. I would NOT want to be a PM doc in Tennessee. I actually like the fact that I am watched so closely over my meds. It keeps everyone on top of what and how much I take. Don't know about you, but I write it down in a medicine journal everytime I take something. Pain meds can make you loopey and with my journal, I don't make mistakes because I'm in la-la land! Also, I bring my journal to my PM appts and my doc can look at it and suggest new times and ways to take my meds if need be. Hope that helps a little. Also, if you are not as of yet locking up your meds, please start! Not saying anyone you know would steal your meds, I just think its better to be safe than sorry. Karen

I'm in North Carolina and I'm not sure of the "rules" pertaining to this.
If indeed this is the situation I'm ok...

The 3 ways a physician has to Monitor Adherence of Controlled Substances:
1) Prescription Monitoring Programs 2)Random drug tests 3)Pill counts.


http://health.utah.gov/prescription/...cer%20pain.pdf

"Drug education for physicians, providers, and patients is crucial. While it appears that certain medications have revolutionized the treatment of chronic pain in the United States, physicians must balance medical need with the possibility of abuse and diversion, as well as the necessity to comply with state and federal regulations. It is obvious that healthcare practitioners are not only expected to prescribe medications when there is medical need and document appropriately, but they are also expected to prevent illegal diversion and identify drug abuse. Consequently, education is a critical component of any program to control the diversion of prescription drugs."

DIVERSION=Patients selling their meds.

"Records should remain current and be maintained in an accessible manner and readily available for review, not only for the physician and other members of the practice, but also the authorities. To be in compliance with controlled substance laws and regulations required to prescribe, dispense, or administer controlled substances, the physician must have an active license in the state and comply with applicable federal and state regulations. Various boards have published regulations and recommendations for prescribing controlled substances. Physicians are advised to refer to these regulations for their respective state.


Pill Counting is a common device for docs to monitor their patients compliance with opiates and other controlled substances.

Whether "pill counting" is specifically addressed or simply implied under the umbrella of Monitoring Adherence, there certainly are rules for docs to make sure their patients are not overusing or selling their meds.

The Prescription Monitoring Programs are Big Brotheresque, IMHO.

If you're concerned you're being singled out, it is highly doubtful. Just ask the office if random pill counts, for patients prescribed controlled substances, is an office policy. Or better yet, if your doc required you to sign a Controlled Substance Agreement, check it!

F.Y.I.,
Well all the fuss for nothing. I saw my neurologist today and all she really wanted was a list of meds.
She talked to me and gave me some tests and determined that my RSD is spreading to my leg and almost my entire left side. She told me that in the future she will have me scheduled for a MRI again to see how far degenerated my atrophy has gone. At this point all that can be done is to treat and monitor the symptoms and that the RSD is complicating matters...

That's why I waited to write out the long explanation. Hopefully it will be of use to someone else that's concerned and researching the issue in the future.

And can I say I told you so? Look at my post #7.

The neurologist requesting this was the tip off.

Just a suggestion for people. Always count your narcotic pills as soon as the pharmacy gives them to you. One time the pharmacy shorted me 2 pills and I called them. Fortunately, they didn't give me a hard time. I don't want to run out plus if there was someone at the pharmacy that was shorting peoples prescriptions by 1 pill it wouldn't take long for someone to pocket the extra meds.

nyt2,

One of the first suggestions my PM doctor at the time gave when I was taking a regular schedule of many meds.,was 1-count everything when you get home and 2-lock everything up. Why lock everything up because not your family but you never know who goes in your medicine chest. And he was right I was robbed my a cleaning person when I was first injured, she took everything. I had to call the police ofcourse she denied it. It was a hassle my doctor had to get involved in order to get the medication again, which I had just filled 4 days prior to this happening. I'll never forget it, here she is seeing me in such a horrible condition, the first couple of years was a nightmare, and without any regard she takes my medication which at the time I was having surgery after surgery and I needed them.

PM doctors have to me very careful, my problem was back in 2006 or so. Things are even worse now from what I here. So honestly I can't blame them for protecting themselves.

gabbycakes