Pain Medication and Controlled Substance Policy (General)

Audience: all

Pain medications, including controlled substances, are often used to manage moderate to severe pain. These medications can provide relief but also carry risks such as dependence, side effects, and misuse. Telemedicine can help provide guidance on pain management and discuss medication options safely. However, prescribing controlled substances usually requires careful evaluation and monitoring, which may sometimes need in-person visits. Understanding the policies around pain medication, safe use, and monitoring can help patients and providers work together effectively. This guide explains key points about pain medication policies, what telemedicine can and cannot do, and how to prepare for and follow up after telemedicine visits related to pain management.

Red flags — go in person / ER

• Severe allergic reaction signs (e.g., swelling, difficulty breathing) — seek emergency care immediately.
• Sudden worsening of pain or new symptoms like numbness or weakness — contact your healthcare provider promptly.
• Signs of overdose such as extreme drowsiness, slow breathing, or inability to wake up — call emergency services right away.

What telemedicine can do

• Reviewing pain symptoms and history.
• Providing education on pain management options.
• Discussing risks and benefits of pain medications.
• Monitoring treatment progress and side effects.
• Coordinating care with other healthcare providers.

What telemedicine cannot do

• Performing physical examinations requiring hands-on assessment.
• Administering controlled substances without prior in-person evaluation when required.
• Managing acute emergencies or overdose situations.
• Conducting drug screening tests onsite.

Understanding Pain Medications and Controlled Substances

Pain medications range from over-the-counter options like acetaminophen and ibuprofen to stronger prescription drugs known as controlled substances (e.g., opioids). Controlled substances are regulated due to their potential for addiction and misuse. They are typically prescribed only when other pain treatments are insufficient. Safe use includes following dosage instructions, recognizing side effects, and avoiding mixing with alcohol or other drugs.

Telemedicine’s Role in Pain Management

Telemedicine can provide education about pain management, review symptoms, and discuss medication options. Providers can assess pain levels, suggest non-drug therapies, and monitor ongoing treatment. However, prescribing controlled substances often requires additional safeguards, such as verifying identity and conducting physical exams, which may be limited remotely. Telemedicine visits often serve as part of a broader care plan including in-person care.

Policies and Safety Measures

Healthcare providers follow strict policies to ensure safe prescribing of controlled substances. These include verifying patient history, using prescription monitoring programs, and setting treatment goals. Patients should be honest about their pain and medication use. Providers may require regular follow-ups to adjust treatment and reduce risks of misuse or side effects.

Preparing for Your Telemedicine Visit

Before your telemedicine appointment, prepare a list of your current medications, pain symptoms, and any concerns. Ensure you have a private, quiet space with a reliable internet connection. Have a way to take notes and be ready to discuss your medical history openly. This preparation helps providers make safe and effective recommendations.

After Your Telemedicine Visit

Follow the provider’s instructions carefully, including medication use and any recommended lifestyle changes. Schedule any follow-up appointments as advised. Report any side effects or worsening symptoms promptly. Keep all medications secure and do not share them with others.

How to prepare for your tele-visit

• List all current medications, including over-the-counter and supplements.
• Note your pain levels, location, and any factors affecting pain.
• Prepare questions or concerns about your pain or medications.
• Ensure a private and quiet environment for the tele-visit.
• Have your identification and medical records accessible if needed.

After your tele-visit

• Follow medication instructions exactly as prescribed.
• Monitor for side effects or changes in pain and report them.
• Attend any scheduled follow-up appointments.
• Store medications securely and dispose of unused drugs safely.
• Avoid sharing medications with others and do not alter dosages without consulting your provider.

FAQs

Can I get a prescription for pain medication through telemedicine?

Telemedicine providers often can discuss pain management and may prescribe medications. However, prescribing controlled substances usually requires careful evaluation and may sometimes need an in-person visit depending on local regulations and clinical judgment.

What should I do if I experience side effects from my pain medication?

Contact your healthcare provider promptly to discuss your symptoms. Do not stop or change your medication without professional advice, as some medications require gradual changes.

How can I safely use pain medications to avoid addiction?

Use medications exactly as prescribed, avoid taking more than recommended, and communicate openly with your provider about your pain and any concerns. Providers will monitor your treatment to minimize risks.

Are there alternatives to controlled substances for pain management?

Yes, alternatives include non-opioid medications, physical therapy, psychological support, and complementary therapies. Your provider can help identify options suitable for your condition.

What should I do if I miss a dose of my pain medication?

Follow the instructions provided with your medication. Typically, take the missed dose as soon as you remember unless it is close to the time for your next dose. Do not double the dose to catch up.

Sources

1. Pain Management — MedlinePlus | U.S. National Library of Medicine / National Institutes of Health.
2. Guideline for Prescribing Opioids for Chronic Pain — Centers for Disease Control and Prevention (CDC).
3. Pain Medication: What You Need to Know — Mayo Clinic.
4. Prescription Drug Monitoring Programs (PDMPs) — National Library of Medicine.
5. Safe Use of Opioids for Pain Management — Substance Abuse and Mental Health Services Administration (SAMHSA).

This guide provides general information about pain medication and controlled substance policies in the context of telemedicine. It is not a substitute for professional medical evaluation, diagnosis, or treatment. Always seek in-person care or emergency services when needed, especially for urgent or severe symptoms.