[NP-Clinical] Narcotics, HIPPA and the Law

[Theodore Scott]

The California BRN and the DEA would no doubt answer "yes" to both scenarios

 

Ted Scott, NP-C

 

  _____  

From: np-clinical-bounces at nurse.net [mailto:np-clinical-bounces at nurse.net]
On Behalf Of Barbara C. Phillips
Sent: Wednesday, August 01, 2007 7:49 PM
To: 'NP Clinical'
Subject: [NP-Clinical] Narcotics, HIPPA and the Law

 

What would you do?

 

1.      You are treating a 67 year old man for chronic back pain after
several failed surgeries. You see that his pain is not adequately
controlled, yet he does not want to increase is medication (Vicodin).
Several months later, you find out he was some how making copies of your
prescriptions and taking them to various pharmacies around town.never
hitting the same one more than once a month (getting about three times what
you prescribed). He agrees to go to treatment. He gets no further pain
medication - at least not from you.  Would you have reported this to the
police?

 

2.     59 year old man with chronic pain and PKD has been on oxy's for
several years and is documented by his previous providers as having no
problems with medications. Documentation includes formal pain assessment,
stating treatment is appropriate. You get a call today from a pharmacy 2
hours away that he just filled a prescription - "brand name please" (and
paid cash). However, when investigating, he just got that script at the
appropriate pharmacy the day it was written.in town. And it turns out he
filled a script for nearly the same medication from a physician 3 hours away
(we had a nice long chat). Further investigation shows multiple pharmacies,
providers and three counties. In this last incident (today), I've notified
all involved pharmacies and providers, and faxed a copy of the discharge
latter to the nephrologists. But do I notify the police?

 

Does a patient retain the right to confidentiality in these scenarios? I do
have medication contracts for controlled substances, but you know.it does
not say anything about legal action if it is violated (which I will correct
immediately). 

 

I feel like not doing something essentially allows the patient to see the
next provider and start all over again.  

 

I'm looking forward to your comments.

 

 

Barbara C. Phillips, NP

www.NPBusiness.ORG <http://www.npbusiness.org/>  

 

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