Opiates/Controlled Substances

I do not prescribe schedule 2 opiates (hydrocodone, oxycodone, morphine, codeine, methadone) for long term pain control.  Opiates can be effective at reducing pain in the short-term, but long-term they make the pain situation worse.  Taking a benzodiazepine (alprazolam, lorazepam, clonazepam, diazepam) together with an opiate is unsafe.  I will not prescribe these medications to be taken together.  Some people will be dependent on both of these medications, in which case I will supervise a wean off to a safer option.  If you take these medications, there are a few options at my office.

1.  I will help you wean off opiate medication.  I will prescribe rare, intermittent "rescue use" opioids in the long run.

2. I will be your primary doctor and you can see a pain managment specialist for your pain medicatons.

3. You can find a different primary care doctor that will prescribe opiates daily, or prescribe a combination of opiate and benzodiazepine medications.

I will strictly adhere to specific controlled substance policy paperwork you will sign at your visits.

Marijuana

Medical and recreational marijuana are now both legal to use in Michigan. This presents some potential issues with medications that I prescribe.

Marijuana products are unsafe to use with opiates, benzodiazepines and/or stimulant medications. If you take any of these prescription medications, you cannot use marijuana in any way. You can be a patient at my office and use marijuana for medical or recreational purposes, however I will not prescribe you any of these medications.

I support your individual rights under these new laws that were decided by Michigan voters. I also have a responsibility as your doctor to make sure the drugs you put into your body don’t interact with each other. An example of this is a person who legally exercises her right to smoke cigarettes should not be prescribed hormone replacement or birth control as this could cause a deadly or disabling blood clot or stroke. I would never prescribe birth control pills to a woman who smokes, just like I will never prescribe opiates, benzodiazepines or stimulants to a person who uses marijuana.

Drug Monitoring

If you take any of the above opiates, benzodiazepines or stimulants (Adderall, Concerta, Vyvanse, Mydayis, Focalin, Ritalin or their respective generic drugs) I will regularly monitor your urine for adherence to our prescription plan. Adherence to our prescription plan means that you are taking the medications that I prescribe the way that I prescribe them AND that you are not taking other medications/drugs that I am not prescribing. If I request a urine sample for prescription drug monitoring, you must produce a urine sample before leaving my office. If you can’t produce a urine sample I will no longer prescribe any of these medications.

**Some insurance plans may require you to pay for testing such as this prescription monitoring until you reach your deductible. This testing typically costs $75-250.