Algos Research Opiate Abuse Point System
One point: *calls in early for meds due to running out early with up to 25% overuse;
*lost or stolen script;
*non-emergent physician contact regarding opiates on nights or weekends; telephone
*report (anonymous) that patient is selling drugs (DRUG SCREEN AND PILL COUNT
IMMEDIATELY)
*family report that patient is impaired (Pill count)
Two points: *Fails to show up for procedures or PT but shows up for opiate
prescribing
*Telephone report (identified) that patient is selling drug (must call police)
*Marijuana in drug screen
*One time episode of multiple prescribers of narcotics
*Overuse of meds by 50% without physician authorization
Three points: **Police reports patient is selling drugs
**Overdose resulting in hospital admission (non-iatrogenic)
**Prescription alteration
**Cocaine, methamphetamines, heroin, etc in drug screen
**Refusal to take drug screen in allotted timeframe or have a pill count
**Chronically (>2 months) obtaining narcotics from multiple prescribers
**Hostile or threatening behavior in order to obtain narcotics (call police: extortion)
Consequences of substance abuse
3 points in a year: no narcotics for at least a year, then may re-institute with
controlled monitoring with frequent follow-up and mandatory psychology visits.
If overdose, then addictionology consult is necessary.
2 points: Written warning to patient
1 point: Verbal warning
Confirmed diversion (prescription alteration, arrest and conviction for selling
drugs or manufacturing illicit drugs) should result in a permanent elimination
from the medical practice.