Managing Addictions

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Transitioning Care in the Face of Painkiller Addiction or Abuse

by Dr. Mike on

Have you often considered that one of the most complex and challenging areas of modern medicine involved treating patients with chronic conditions, with medications otherwise prone to abuse? These are medications that have a readily achievable dose threshold for lethal toxicity. Many of these chronic conditions are highly subjective in nature such as pain, anxiety, or attention problems. You and your primary care staff have the primary goal of improving the quality of life for your patients; yet how do we balance a gamble to improve any given individual’s quality of life, against outcomes like addiction, diversion, overdose, and death?

Resources for Primary Care Clinical Leaders, Administrators, and Office Managers

Resources for Primary Care Clinic Leaders, Administrators, and Office Managers

This is a defining question of our time in modern medicine. Greater than 225 million prescriptions are written each year for prescription controlled substances in the US. The majority of practical guidance for managing patients receiving controlled medications comes in the form of State and Federal regulation, and provider CME (a large portion is dependent on funding from drug manufacturers).

We need to focus on building both clinical and administrative leaders within organizations, and solid organized approaches for your staff to facilitate reasonable and prudent care for patients.

Providers are not the only ones who are scared, frustrated, and confused; whether it is patient safety, professional liability, or regulatory compliance.  These issues impact the entire clinic, including the other patients in the waiting room filling out satisfaction surveys.

• How do you transform your clinic so that your provider team is the respected authority in their patients’ care?

• How do you optimize  “support” from support staff, so care decisions are reasonable, not unduly driven by crisis or drama?
• How do you manage pushback, when patients may otherwise react with hostility?
• How do you communicate expectations to patients, or resolve problems with proper accountability?
• How do you connect patients to needed help, when they need a different kind of help than your clinic provides?
• How do you reduce friction among staff, and define standards even where prescribing styles are diverse?
• How do you avoid regulatory and malpractice problems relating to addiction, overdose, and death?
• How do you maintain a connection to the patient, when it feels rigged towards contempt and disconnect?

These are some of the questions I am going to address in a 1 hour live Webinar called Transitioning Care in the Face of Painkiller Addiction and Abuse. You can get details of registration at

About Dr. Mike

Michael Schiesser MD is a physician, speaker, consultant and expert in addictions. View all posts by Dr. Mike →