1. Pain Management- Hydrocodone Lara Offenburger PA-C No Disclosures ©AAHCM

2.  Inability to see specialists  Tolerance  Liability/Documentation Issues  Diversion  Logistical challenges of Triplicate medication ©AAHCM

3.  Team up with Pain Management Specialists if possible  Educate yourself on transportation options for the insurance plans in your area  Use of longer acting opiates with short acting for breakthrough pain  Always consider alternative therapy choices and document why/why not appropriate ©AAHCM

4.  Liability and Documentation issues  Use a Pain Management Model  Monthly visits- Be Safe!  Utilize state prescription drug tracking- http://www.pdmpassist.org/content/state- profiles  Know your state medical board’s documentation guidelines  SAFE opiate prescribing CME ©AAHCM

5.  Pain Management Model- random regular UDS/buccal swabs for tox  Utilize DPS reports  Have policies regarding early refills  Have policies for “stolen” medications  Opiate contract with patients ©AAHCM

8.  Internal tracking with mailed rx  Central Delivery Pharmacy  Blister packs to monitor usage Appt Dates prior to refills for pill counts  Mobile lab for UDS/buccal swabs  Educate on yourself on false positives on tox  Utilize Home Health Skilled nursing to obtain specimens on patients with indwelling or suprapubic catheters ©AAHCM

9.  Give Good Patient Care  Protect Your License  Educate Educate Educate  Be SAFE- Strategies, Assessment, Fundamentals, Education ©AAHCM