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GMA Controlled Substance Policy

The ongoing opioid crisis in this nation is caused by the widespread misuse of opioid pain medication. On average in the United States alone, there are approximately 115 deaths per day due to opioid overdose.

Here at GMA, we care about your pain management and psychological health, and want to help you or your loved one stay safe. We recognize the validity and importance of these medications, but we also understand there are significant risks involved when taking these medications.

OUR GOAL IS TO PROVIDE THE MOST EFFECTIVE TREATMENT FOR CHRONIC PAIN, ANXIETY, & INSOMNIA, AND TO MINIMIZE THE RISK OF ADDICTION, DIVERSION, AND ACCIDENTAL OVERDOSE INHERENT IN THESE HIGH-RISK MEDICATIONS.

Our chronic controlled substance policy, designed by GMA physicians, is carefully monitored to provide safe and effective medication management. Our providers follow the opioid-prescribing guidelines set forth by the Centers for Disease Control (CDC) and Colorado medical boards.

In accordance with GMA’s policy and state and federal guidelines, all GMA patients who are prescribed certain controlled medications that treat CHRONIC PAIN (opioid medications) or ANXIETY or INSOMNIA (benzodiazepine medications) every day for more than 90 days can expect:

 

  • In-office visits every 3 months
  • Required urine drug screening at least once per year, unannounced
  • Signing an agreement with your provider once per year
  • Working with your provider to use other resources to help with pain control, anxiety, or insomnia
  • A prescription for Narcan in addition to your other medication (only for patients taking an opioid medication)

FAQs

Can I refuse the drug test? Am I getting tested because my provider thinks I am misusing my medication?

No. You will not be able to receive your prescription if you refuse a drug screen. We encourage all of our patients to be open and honest with their providers when discussing the medications, supplements, and other drugs that they are taking. These conversations are vital to the patient-provider relationship and quality care.

The annual urine drug screening is required as part of our policy for all patients chronically taking opioids or benzodiazepines, and is recommended by both the CDC and Colorado state medical boards. Urine drug tests can provide information about drug use that is not reported by the patient, especially drugs that can increase the risk for overdose.

Will marijuana or alcohol show up in the drug screen?

Yes; THC and alcohol will be detected and reported if your body contains sufficient amounts of these substances at the time of testing. We do not recommend the use of marijuana or alcohol while using opioids or benzodiazepines due to safety concerns. Mixing the two can lead to serious complications or even death.

We also understand that these substances are legal in the state of Colorado, so we encourage you to discuss safe usage with your provider while on these medications.

How much does the drug screen cost? How do I pay for it? Why is it so expensive?

All billing and payments for the drug screens done through HealthTrackRx are done by that company, not by GMA.

HealthTrackRx charges approximately $525 for the drug screen. Patients can expect to see a bill from HealthTrackRx within 1-2 months after testing. They will bill insurance first; how much insurance pays is dependent upon your insurance policy. If you are self-pay, please call HealthTrackRx at 844-218-3097 to see if you qualify for a reduced rate.

If you have questions about your drug screen bill or want to set up a payment plan, please call HealthTrackRx at 844-218-3097. You can also pay your bill online.

GMA’s laboratory also has brochures available with more information regarding drug screen billing.

GMA chose to use the SureTest drug screen through HealthTrackRx because of its accuracy, broad range of substances screened for and detected, and overall cost compared to similar screens offered by other companies. Because this test is so comprehensive and accurate, it is expensive to do.

I’ve heard that stress can make pain or anxiety worse. How can I reduce stress in my life?

There are many ways to help reduce stress in your life. Things such as routine exercise, healthy eating habits, talking to someone, writing your thoughts down, yoga, deep breathing exercises, or meditating are all ways to help reduce stress. As always, talk to your provider about ways that can work best for you.

If I ask for help, will my provider assume that I am ready to come off of my medication?

Tapering off medication is a process that should be monitored carefully with your provider’s guidance. We encourage you to have an open and honest relationship with your provider. We want you to actively participate in your treatment plan. Your physician will provide you with the recommendations that best suit your needs, but we encourage you to work together on how to proceed with your individual plan.

Is medication my only option?

Other ways of relieving your pain, anxiety, and insomnia are available, either in place of medication or in combination with medication. Talk to your provider if you are interested in other forms of relief. Options that have been successful include physical therapy, yoga, massage and acupuncture.

If I cut back on my medication and then have a setback in pain or anxiety, can my provider increase my dose again?

Yes, you can work with your provider to be at a safe dose for proper relief. When it is time, you can work together to cut back on your medication.

Why has my provider told me that I can no longer take my opioid medication (for pain) with my benzodiazepine medication (for anxiety or insomnia), even though I’ve been taking both for years?

Recent studies have shown that taking these medications together puts patients at greater risk for potentially fatal overdose. Tapering off medication is a process that should be monitored carefully and with your provider’s guidance. We encourage you to have an open and honest relationship with your provider. We want you to actively participate in your treatment plan. Your physician will provide you with the recommendations that safely suit your needs, but we encourage you to work together on how to proceed with your individual plan.

What happens if I break the agreement I signed with my provider?

Intentionally breaking your agreement could lead to discontinuation of all controlled substance prescriptions or even dismissal from the practice. We encourage you to always be completely open and honest with your provider in order to prevent any confusion or misunderstanding.

What happens if another provider prescribes another controlled medication for me after surgery or a traumatic event?

You should always be completely open and honest about the medications you are taking with all of your providers. According to the agreement you sign every year, all controlled substance prescriptions must come from your provider at GMA or, during his/her absence, by the covering physician, unless specific authorization is obtained. We recommend that you tell your non-GMA providers about all of the medications you are taking and about the agreement you signed at GMA. Whenever possible, discuss the potential of additional prescriptions with your provider at GMA prior to scheduled surgery. If that is not feasible, be sure to call your GMA provider the next business day.

Intentionally getting prescriptions for controlled substances from multiple providers is considered a breach of your agreement with your GMA provider. Repercussions could include discontinuance of all controlled substance prescriptions and even dismissal from the practice.

Why do I need to fill my prescription at the same pharmacy every time?

The pharmacist is a member of your overall healthcare team. They are trained to help make sure you are safely taking prescribed medications. As part of this, they will work to ensure that they have an updated diagnosis and other information from your provider. If a pharmacist feels that filling your controlled substance medication is not in your best interest or if they do not have all of this information already on file, they can postpone filling your medication or deny it altogether.