Posted by greywolf on April 7, 2007, at 1:18:28
In reply to Re: Doctors irresponsible with Xanax » greywolf, posted by Fivefires on April 6, 2007, at 18:33:13
> If this were to occur in my lifetime, and, I'd not found anything which offers near the relief or supports it (FLOBW), I'm confident I would be one of thousands of peeps who would suffer and raise a an argument of misconduct of prescribing and its resultant damage to myself.
>
> I'll present this ? to my P next month.
>
> Tks, 5f
I'm not sure that this is directly responsive to your post, but take a look at this old memo that's on Dr. Bob's pharmacology tips page:
Date: Fri, 22 Dec 1995 09:34:27 -0800 (PST)
From: "H. Westley Clark" <carter@itsa.ucsf.EDU>
Subject: Long-term treatment with benzodiazepinesLong term benzodiazepine treatment may be indicated in select patients. You, of course, must have a strict treatment plan--ideally, written and signed by the patient.
The patient must be apprised of the dependency syndrome associated with even low dose chronic benzodiazepines. The patient should be made aware of tolerance and withdrawal syndromes. Even if the stress is time limited, e.g., a new job, the issues of physiological dependence must be carefully explained.
If you choose to proceed, prescriptions should be regulated carefully. Refills should not be automatically granted. The prescription should be re-evaluated every 30 days. You should agree on an initial fixed time period for the prescription. You should agree on a maximum time period for the prescription.
You should have a toxicology screen for illicit substances performed before initiating the prescription. You should verify through the interview and contact with other physicians whether there is a history of alcohol or drug abuse.
You should require the patient to use one and only one pharmacy. Every 6 months, you should contact the pharmacist and review the prescribing history and detail the prescribing plan.
If you prescribe for more than a year, you should recommend that a case conference occur, with all involved practitioners (or their representatives) attending.
The reluctance of physicians to prescribe for long periods of time is not surprising, given that the Medical Board, the DEA, and the patient may seek recourse for inappropriate prescribing.
The medical rationale for the use of chronic benzos should be carefully established and documented. The fact of medical benefit from the benzos should be carefully established and documented. By involving all parties, even the patient's signficant other (if there is one), the physician can establish a medical purpose for the prescribing.
Periodic physical examinations by the prescribing physician or at least by the treatment team is also critical.
This sounds like a lot. It is. However, if the flak comes, it is best to be covered.
__________________________________
I don't think those views have disappeared.
poster:greywolf
thread:747227
URL: http://www.dr-bob.org/babble/20070402/msgs/747779.html