It is possible to provide the best care for a patient and protect yourself from criminal and civil liability. In fact, when you do one right, you do the other right as well. Typically you want to look for three things as a prescriber of any controlled prescription medication, opioid or otherwise. You want to make sure there is a legitimate medical need. You have to make sure that the person is actually enduring a condition that cannot be treated without the controlled medication that you know now is necessary to prescribe. You also need to make sure that you adhere to what is the ordinary course of your professional practice. And so, you look to guidance through prescriber education, through your professional associations and the training materials that are put out by them, as well as entities like the FDA and labeling for medications. You pull all that together and do what is consistent with the standard of care.
Thirdly, you take reasonable precautions to prevent harm from the controlled prescription medications. That includes things like checking the prescription monitoring program, counseling your patients on the risks and how to take the medication appropriately, store it safely, dispose of it properly, making sure that you do urine drug testing on occasion, and that if there is something that’s different from what was expected in those results, that you take action and adjust the treatment plan. With those three things adhered to--the legitimate medical need, ordinary course of professional practice, and reasonable steps to prevent harm--then you do thorough documentation of all of it, and make sure that it’s in the medical record, individualized to the person you’re treating, and you will be pretty solid in knowing that you’re giving the best care, and you’re safe from civil and criminal liability.