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ORLANDO – When opioids are prescribed for chronic pain patients, following the five-step VIGIL system can lessen the threat of being scrutinized by the Drug Enforcement Agency.
The acronym stands for verification, identification, generalization, interpretation, and legalization, said its developer, David B. Brushwood, at the annual clinical meeting of the American Academy of Pain Management.
“The old advice that says doctors will be okay as long they practice good medicine and document their actions thoroughly is wrong. I don't agree with it. These things may get you out of trouble once you are in it, but I want to teach you how to stay out of trouble in the first place,” said Mr. Brushwood, who is a professor of pharmacy health care administration at the University of Florida, Gainesville.
▸ Verification. This is the first step in staying out of legal trouble, and this step involves one of three options, according to Mr. Brushwood. Verify use of schedule II opioids with a previous prescriber; start the patient out on a nonopioid to see how he or she deals with the medication; or call a trusted colleague.
▸ Identification. “Ask for government-issued photo ID of anyone being prescribed or picking up a prescription for opioids for hydrocodone/acetaminophen, including someone who says he is coming in to pick up his mom's OxyContin,” said Mr. Brushwood, a Mayday Scholar with the American Society of Law, Medicine, and Ethics.
▸ Generalization. “Keep all controlled substances under lock and key; use only one pharmacy for your controlled substance drugs; and work closely with your pharmacist,” he advised.
▸ Interpretation. This fourth step involves using brief questionnaires, such as the Drug Abuse Screening Test (DAST) and the Screener and Opioid Assessment for Patients with Pain (SOAPP) tests.
“When you interpret the results of these tests, you can ask yourself whether you now feel comfortable allowing the patient to have controlled substances,” Mr. Brushwood said.
This step also will help to differentiate between the chronic pain patients and the “fakers and liars.”
▸ Legalization. This final step “means staying squeaky clean with regard to meeting your legal requirements,” he said. Follow state and federal laws for controlled substances, and make no exceptions.
The first step in staying out of legal trouble is patient verification. MR. BRUSHWOOD
ORLANDO – When opioids are prescribed for chronic pain patients, following the five-step VIGIL system can lessen the threat of being scrutinized by the Drug Enforcement Agency.
The acronym stands for verification, identification, generalization, interpretation, and legalization, said its developer, David B. Brushwood, at the annual clinical meeting of the American Academy of Pain Management.
“The old advice that says doctors will be okay as long they practice good medicine and document their actions thoroughly is wrong. I don't agree with it. These things may get you out of trouble once you are in it, but I want to teach you how to stay out of trouble in the first place,” said Mr. Brushwood, who is a professor of pharmacy health care administration at the University of Florida, Gainesville.
▸ Verification. This is the first step in staying out of legal trouble, and this step involves one of three options, according to Mr. Brushwood. Verify use of schedule II opioids with a previous prescriber; start the patient out on a nonopioid to see how he or she deals with the medication; or call a trusted colleague.
▸ Identification. “Ask for government-issued photo ID of anyone being prescribed or picking up a prescription for opioids for hydrocodone/acetaminophen, including someone who says he is coming in to pick up his mom's OxyContin,” said Mr. Brushwood, a Mayday Scholar with the American Society of Law, Medicine, and Ethics.
▸ Generalization. “Keep all controlled substances under lock and key; use only one pharmacy for your controlled substance drugs; and work closely with your pharmacist,” he advised.
▸ Interpretation. This fourth step involves using brief questionnaires, such as the Drug Abuse Screening Test (DAST) and the Screener and Opioid Assessment for Patients with Pain (SOAPP) tests.
“When you interpret the results of these tests, you can ask yourself whether you now feel comfortable allowing the patient to have controlled substances,” Mr. Brushwood said.
This step also will help to differentiate between the chronic pain patients and the “fakers and liars.”
▸ Legalization. This final step “means staying squeaky clean with regard to meeting your legal requirements,” he said. Follow state and federal laws for controlled substances, and make no exceptions.
The first step in staying out of legal trouble is patient verification. MR. BRUSHWOOD
ORLANDO – When opioids are prescribed for chronic pain patients, following the five-step VIGIL system can lessen the threat of being scrutinized by the Drug Enforcement Agency.
The acronym stands for verification, identification, generalization, interpretation, and legalization, said its developer, David B. Brushwood, at the annual clinical meeting of the American Academy of Pain Management.
“The old advice that says doctors will be okay as long they practice good medicine and document their actions thoroughly is wrong. I don't agree with it. These things may get you out of trouble once you are in it, but I want to teach you how to stay out of trouble in the first place,” said Mr. Brushwood, who is a professor of pharmacy health care administration at the University of Florida, Gainesville.
▸ Verification. This is the first step in staying out of legal trouble, and this step involves one of three options, according to Mr. Brushwood. Verify use of schedule II opioids with a previous prescriber; start the patient out on a nonopioid to see how he or she deals with the medication; or call a trusted colleague.
▸ Identification. “Ask for government-issued photo ID of anyone being prescribed or picking up a prescription for opioids for hydrocodone/acetaminophen, including someone who says he is coming in to pick up his mom's OxyContin,” said Mr. Brushwood, a Mayday Scholar with the American Society of Law, Medicine, and Ethics.
▸ Generalization. “Keep all controlled substances under lock and key; use only one pharmacy for your controlled substance drugs; and work closely with your pharmacist,” he advised.
▸ Interpretation. This fourth step involves using brief questionnaires, such as the Drug Abuse Screening Test (DAST) and the Screener and Opioid Assessment for Patients with Pain (SOAPP) tests.
“When you interpret the results of these tests, you can ask yourself whether you now feel comfortable allowing the patient to have controlled substances,” Mr. Brushwood said.
This step also will help to differentiate between the chronic pain patients and the “fakers and liars.”
▸ Legalization. This final step “means staying squeaky clean with regard to meeting your legal requirements,” he said. Follow state and federal laws for controlled substances, and make no exceptions.
The first step in staying out of legal trouble is patient verification. MR. BRUSHWOOD