Patient Notification When Prescribing Opioids

Provided by Dr. Aaron Stevens

As my driver’s license picture shows, I used to be a bit more (cough) “rotund.” I like Doritos. Problem is, I hate tight clothes and am too cheap to buy new ones. I was at an impasse and had to make a change. I developed some new eating habits, and the weight came off. Fast forward a few years and enter COVID. Stress goes up, schedules get weird, my shiny new habits go out the window, and now my clothes are tight again. My scrubs are my warning system and the strained seam threads are screaming that it is time to reinstitute the better habits before some something “untoward” happens.

 These aren’t the only new habits that have fallen off during COVID. There is an uptick in prescribers sliding back toward old recordkeeping habits.

 Under new (ish) law, WAC 246-817-907, we are required to perform the following at first opioid prescription or transition between phase of treatment.

1. We must discuss with the patient the risks of the use of opioids, including risk of dependence and overdose, and document this discussion in the chart.
2. The patient must be informed of pain management alternative to opioids (typically ibuprofen and Tylenol).
3. The patient must be informed of safe and secure storage of opioid prescriptions.
4. The patient must be informed of the proper disposal of opioid medications, including, but not limited to the availability of drug take back programs.
5. The patient must be informed of their right to refuse an opioid prescription and document any refusal (they can also revoke it, by the way).

Item 1 above must be from the dentist and conversation documented. Items 2-5 may be in written form, here is a handout that can be used. All must be demonstrable in the record. In my office, I discuss No. 1 and write it in my notes. I also give the patient a handout meeting 2-5 and attach it to their electronic file. I’m covered, and it’s honestly pretty easy.

Toolkits are available to help make practitioners aware of the new requirements. They include:

• The new rules
• Dentist handout
• Dentist checklist
• Patient handouts
• Educational video explaining the new requirements

So, it’s time to reel things back in, refocus, and get habits back under control. Docs, let’s make sure we are following the legal requirements above. If you can do that, I can get my eating habits managed. I’ll feel better, give my scrubs a much-needed break, and be ready for a much better driver’s license picture.