Controlled Substances Prescribing: What Every Provider

North Carolina Medical Board wwwncmedboardorg | infoncmedboardorg

North Carolina Medical Board 1203 Front Street | Raleigh NC 27609

wwwncmedboardorg | infoncmedboardorg 8002539653

Controlled Substances Prescribing

What Every Provider Needs to Know

Brooke A Chidgey MD Clinical Assistant Professor of Anesthesiology University of North Carolina School of Medicine


Learning Objectives

bull Promote best practices for managing chronic pain and prescribing controlled substances through the CDC Guideline

bull Identify strategies for recognizing signs of misuse and abuse of prescription opioids

bull Describe strategies for communicating with patients about avoiding or reducing prescription opioids



CURRENT STATE


North Carolina


North Carolina

00

50

100

150

200

250

300

350

400

1968 1970 1972 1974 1976 1978 1980 1982 1984 1986 1988 1990 1992 1994 1996 1998 2000 2002 2004 2006 2008 2010 2012 2014

Death

s p

er

1000

00 p

op

ula

tio

n

Year

Motor Vehicle Traffic (Unintentional)

Drug Poisoning (All Intents)

Firearm (All Intents)

α

1989 ndash Pain added as 5th Vital Sign

Per 10000 age-adjusted to the 2000 US Standard Population α - Transition from ICD-8 to ICD-9 β ndash Transition from ICD-9 to ICD-10

National Vital Statistics System httpwondercdcgov multiple cause dataset Source Death files 1968-2014 CDC WONDER Analysis by Injury Epidemiology and Surveillance Unit


North Carolina

North Carolina Rx and Drug Overdose Prevention Partners

Research and Evaluation

Prevention Policy Harm Reduction

Prescription Drug Monitoring

Program

Carolinas Poison Center

Enforcement and Regulation

Pain Patient Support

Data and Surveillance

Drug Take Back

Communication Advocacy

Funding

Pharmaceuticals

Community Coalitions

Local Public Health Substance Use

Disorder Treatment Recovery Services

DPH DMHDDSAS DMA DPS ORH


NCMBrsquos Response

bull Implementing new programs and initiatives

bull Developing resource pages

bull Increasing communication with doctors and PAs through presentations forum articles website notices and social media

bull Participating in workgroups advisory boards

bull Developing and promoting training on opioids



PROGRAMS AND INITIATIVES


Programs and Initiatives

bull Controlled Substances CME Requirement

bull NC Controlled Substances Reporting System (CSRS) oRegistration

oUtilization

bull Adoption of CDC Guideline



CONTROLLED SUBSTANCE SPECIFIC CME REQUIREMENT


Controlled Substances CME Requirement

NCMBrsquos primary goal is to ensure that licensees who prescribe controlled substances ndash

particularly opioids ndash do so in a manner that is safe appropriate and consistent with current

standards of care

Requiring CME in controlled substances prescribing and related topics is one way of

supporting this



bull Effective July 1 2017

bull Complete specific CME

oControlled substances prescribing practices

oRecognizing signs of misuse and abuse

oControlled substance prescribing for chronic pain management



NORTH CAROLINA CONTROLLED SUBSTANCE REPORTING SYSTEM


NC Controlled Substances Reporting System (CSRS)

bull Prescription drug monitoring program

bull Information on controlled substance prescriptions written and dispensed in NC o Aid in patient safety

o Identify patients at risk

o Improve opioid prescribing practices

bull Utilization now considered a best practice when prescribing for pain patients


NC CSRS Query


NC CSRS Query


NC CSRS Query

A

A

B

C

D


NC CSRS

bull New patient or first encounter prescribing controlled substances for patient

bull Intermittently thereafter based on risk

bull Can register a ldquodelegaterdquo to perform queries for you

bull Use best judgment


NC CSRS Data Points

In the 4th quarter of 2016 bull 18 million opioid prescriptions written by

39682 prescribers in NC bull 508279 queries completed in advance

representing a 28 utilization rate bull 23556 prescribers in NC and 1521

delegates registered with CSRS



bull 2016 NC law mandating registration

bull Physicians and PAs who have valid DEA registration

bull Law goes into effect when DHHS and CSRS update the system to meet specific requirements

bull NCMB encouraging voluntary registration






NCMB POSITION STATEMENT ADOPTION OF THE CDC GUIDELINE



CDC Guideline


CDC Guideline

bull Provide safe effective outpatient pain treatment

bull Not intended for patients who are in active cancer treatment palliative care or end-of-life care

bull Recommendations in the Guideline may not meet the needs of all patients ndash use your professional judgment when providing care


CDC Guideline

bull Determining when to initiate or continue opioids for chronic pain

bull Opioid selection dosage duration follow-up and discontinuation

bull Assessing risk and addressing harms of opioid use


CDC Guideline

Section I Determining when to initiate or continue opioids for chronic pain


Recommendation 1

bull Nonpharmacologic and nonopioid therapies are preferred for chronic pain

bull Benefits of opioid use must outweigh risks

bull Should benefit in both pain and function


Function

ldquoPain average interference with Enjoyment of life

and interference with General activityrdquo Assessment Scale


Recommendation 2

bull Before starting opioid therapy establish realistic treatment goals

bull Consider how therapy will be discontinued if benefits are no longer outweighing risks


Recommendation 3

bull Before prescribing opioids discuss the known risks of this therapeutic option

bull Discuss the responsibility of the patients and providers to reduce these risks


Discussion Topics

bull Severe adverse effects and common side effects

bull Risks with other drugs

bull Risks when driving

bull Risks of opiate use disorder

bull Appropriate storage and risk to others

bull Precautions being taken to reduce risk (UDS naloxone pill count PDMP etc)


A Different Discussion

bull Lack of evidence of long-term benefit of opioids for chronic pain

bull Poor efficacy in neuropathic pain

bull Can worsen other pain conditions

bull Opiate-induced hyperalgesia

bull Difficulty controlling post-procedural pain in future


CDC Guideline

Section II Opioid selection dosage duration follow-up and discontinuation


Recommendation 4

bull Use immediate-release medications when initiating opioid therapy


Recommendation 5

bull Prescribe lowest effective dosage

bull Carefully reassess individual benefit and risks when increasing to ge 50 MMEday

bull Avoid increasing to ge 90 MMEday OR carefully justify decision

bull Consult with pain specialist


Recommendation 6

bull When prescribing opiates for acute pain prescribe minimum quantity needed for severe pain

bull 3 days will often be sufficient rarely more than 7 days worth is needed


Recommendation 7

bull Evaluate benefits and harms within 1 to 4 weeks of starting opioid

bull Evaluate at least every 3 months thereafter

bull Taper opioids as necessary


Concerning Behaviors

bull Requesting early refills

bull Missing pills (stolen lost ruined)

bull Inappropriate urine drug screens

bull Obtaining opioids from others

bull Using multiple pharmacies

bull Dishonesty during encounter

bull Appearing sedated


Tapering

bull Reduce dosage by 10-50 weekly

bull Rapid taper over 2-3 weeks for ldquosevere adverse event such as overdoserdquo

bull May need to pause and restart

bull Taper considered successful if patient making progress


CDC Guideline

Section III Assessing risk and

addressing harms of opioid use


Recommendation 8

bull Evaluate risk factors for opioid-related harms

bull Implement strategies to mitigate risk

bull Naloxone for higher risk patients


At Risk Populations

bull Sleep apnea

bull Renal or hepatic insufficiency

bull ge 65 years old

bull Mental health conditions

bull Substance use disorder

bull Prior nonfatal overdose


Recommendation 9

bull Review prescription drug monitoring program for dosages and dangerous combinations

bull Review before initiation of opioid and at least every 3 months


Recommendation 10

bull When prescribing opiates for chronic pain perform urine drug testing before starting opiate therapy

bull Consider repeating at least annually


Urine Drug Screening

bull Looking for

o Illicit drugs

o Prescribed drugs

o Drugs taken but not prescribed

bull Need context for interpretation

o When was last dose

o How does patient take medication


Results

bull What are you testing for

bull Drug metabolites

o Hydrocodone Hydromorphone

o Oxycodone Oxymorphone


Patient Dismissal

bull Do not dismiss patient from practice based on urine drug test result

bull Could be considered abandonment

bull Could leave patient at risk

bull A missed opportunity


Recommendation 11

bull Avoid prescribing opioid pain medication and benzodiazepines concurrently whenever possible


Recommendation 12

bull Clinicians should offer or arrange evidenced-based therapy for patients with opioid use disorder



TurnTheTide

ldquoWe have to stop treating addiction as a moral failing and start seeing it for what it is a chronic disease that must be treated with urgency and

compassionrdquo

ndash Dr Vivek H Murthy United States Surgeon General


Key Points

bull Evaluate YOUR patient

bull Assess individual risks and benefits

bull Avoid opiates if you can

bull Start low and go slow

bull Reassess throughout (days ndash 3 months)

bull 50 MME and 90 MME are NOT strict limits

bull Use opportunities to get patients help

bull Document document document



IMPLEMENTING THE GUIDELINE CASES


Mr H

57yo M presents as a new patient to your clinic He states he has been using opiates for the last

10 years to control his pain His most recent regimen has been Oxycodone ER 60mg twice

daily He is looking to establish care with you to take over his prescription He also takes

pregabalin 100mg twice daily for neuropathy


Further Questioning

Patient has had numerous back surgeries over the years He has tried and failed the following therapies

bull Physical therapy TENS unit home exercises

bull Gabapentin duloxetine topical lidocaine

bull NSAIDs contraindicated due to gastric ulcers

bull Epidural steroid injections


Other Information

bull No alcohol smoking or drug history

bull Works daily at his farm tending to crops and animals

bull Denies side effects to medication regimen except constipation which is controlled through diet


Mr H

bull Patient has remaining pills in bottle with him

bull NC CSRS reveals history of one provider prescribing current regimen for last 4 years

bull No other controlled substances besides pregabalin

bull POC UDS +oxycodone


What Would You Do


Ms M

43yo F presents as a new patient with severe back pain ever since she had her child 4 years

ago She has been taking oxycodone 15mg every 4 hours for pain because nothing else

works She is now out of her medication and needs a refill


Further Questioning

Previous imaging studies with mild disc degeneration Cannot tolerate PT or exercise due to pain Is not willing to try gabapentin or other adjunctive therapies because she ldquoknows what worksrdquo

Patient unable to leave urine specimen

NC CSRS reveals numerous small prescriptions from multiple providers


Next Step


Mr E

51yo M longtime patient on hydrocodoneAPAP 10325mg q6hr prn pain Patient calls for early

refill because going on a trip


2 Months Later

Patient returns but is short on pills because he left some at home in his pill organizer

Urine drug screen performed revealed no substances Patient reported last use was this AM


Now What


Resources

o wwwncmedboardorgprescribingcme

o wwwncmedboardorgsafeopioids

o Dowell D Haegerich T Chou R et al CDC Guidelines For Prescribing Opioids for Chronic Pain MMWR Recomm Rep 201665(No 1) 1-49



Who must comply with new requirement

bull All physicians and PAs who prescribe controlled substances

bull Residents who hold a full medical license

bull Maintenance of Certification participants who prescribe controlled substances

For other questions on the controlled substances CME visit wwwncmedboardorgprescribingcme


Questions

bull Website wwwncmedboardorg

bull Call 18002539653

bull Email infoncmedboardorg


Learning Objectives

bull Promote best practices for managing chronic pain and prescribing controlled substances through the CDC Guideline

bull Identify strategies for recognizing signs of misuse and abuse of prescription opioids

bull Describe strategies for communicating with patients about avoiding or reducing prescription opioids



CURRENT STATE


North Carolina


North Carolina

00

50

100

150

200

250

300

350

400

1968 1970 1972 1974 1976 1978 1980 1982 1984 1986 1988 1990 1992 1994 1996 1998 2000 2002 2004 2006 2008 2010 2012 2014

Death

s p

er

1000

00 p

op

ula

tio

n

Year




α





North Carolina





Program





Drug Take Back


Funding

Pharmaceuticals






NCMBrsquos Response













oUtilization









standards of care


supporting this



















NC CSRS Query


NC CSRS Query


NC CSRS Query

A

A

B

C

D


NC CSRS






NC CSRS Data Points



















CDC Guideline


CDC Guideline





CDC Guideline





CDC Guideline



Recommendation 1





Function




Recommendation 2




Recommendation 3




Discussion Topics















CDC Guideline



Recommendation 4



Recommendation 5






Recommendation 6




Recommendation 7














Tapering






CDC Guideline




Recommendation 8





At Risk Populations

bull Sleep apnea







Recommendation 9




Recommendation 10





bull Looking for

o Illicit drugs

o Prescribed drugs






Results






Patient Dismissal






Recommendation 11



Recommendation 12




TurnTheTide


compassionrdquo



Key Points













Mr H






Further Questioning







Other Information





Mr H






What Would You Do


Ms M





Further Questioning





Next Step


Mr E




2 Months Later




Now What


Resources












Questions


bull Call 18002539653




CURRENT STATE


North Carolina


North Carolina

00

50

100

150

200

250

300

350

400

1968 1970 1972 1974 1976 1978 1980 1982 1984 1986 1988 1990 1992 1994 1996 1998 2000 2002 2004 2006 2008 2010 2012 2014

Death

s p

er

1000

00 p

op

ula

tio

n

Year




α





North Carolina





Program





Drug Take Back


Funding

Pharmaceuticals






NCMBrsquos Response













oUtilization









standards of care


supporting this



















NC CSRS Query


NC CSRS Query


NC CSRS Query

A

A

B

C

D


NC CSRS






NC CSRS Data Points



















CDC Guideline


CDC Guideline





CDC Guideline





CDC Guideline



Recommendation 1





Function




Recommendation 2




Recommendation 3




Discussion Topics















CDC Guideline



Recommendation 4



Recommendation 5






Recommendation 6




Recommendation 7














Tapering






CDC Guideline




Recommendation 8





At Risk Populations

bull Sleep apnea







Recommendation 9




Recommendation 10





bull Looking for

o Illicit drugs

o Prescribed drugs






Results






Patient Dismissal






Recommendation 11



Recommendation 12




TurnTheTide


compassionrdquo



Key Points













Mr H






Further Questioning







Other Information





Mr H






What Would You Do


Ms M





Further Questioning





Next Step


Mr E




2 Months Later




Now What


Resources












Questions


bull Call 18002539653



North Carolina


North Carolina

00

50

100

150

200

250

300

350

400

1968 1970 1972 1974 1976 1978 1980 1982 1984 1986 1988 1990 1992 1994 1996 1998 2000 2002 2004 2006 2008 2010 2012 2014

Death

s p

er

1000

00 p

op

ula

tio

n

Year




α





North Carolina





Program





Drug Take Back


Funding

Pharmaceuticals






NCMBrsquos Response













oUtilization









standards of care


supporting this



















NC CSRS Query


NC CSRS Query


NC CSRS Query

A

A

B

C

D


NC CSRS






NC CSRS Data Points



















CDC Guideline


CDC Guideline





CDC Guideline





CDC Guideline



Recommendation 1





Function




Recommendation 2




Recommendation 3




Discussion Topics















CDC Guideline



Recommendation 4



Recommendation 5






Recommendation 6




Recommendation 7














Tapering






CDC Guideline




Recommendation 8





At Risk Populations

bull Sleep apnea







Recommendation 9




Recommendation 10





bull Looking for

o Illicit drugs

o Prescribed drugs






Results






Patient Dismissal






Recommendation 11



Recommendation 12




TurnTheTide


compassionrdquo



Key Points













Mr H






Further Questioning







Other Information





Mr H






What Would You Do


Ms M





Further Questioning





Next Step


Mr E




2 Months Later




Now What


Resources












Questions


bull Call 18002539653



North Carolina

00

50

100

150

200

250

300

350

400

1968 1970 1972 1974 1976 1978 1980 1982 1984 1986 1988 1990 1992 1994 1996 1998 2000 2002 2004 2006 2008 2010 2012 2014

Death

s p

er

1000

00 p

op

ula

tio

n

Year




α





North Carolina





Program





Drug Take Back


Funding

Pharmaceuticals






NCMBrsquos Response













oUtilization









standards of care


supporting this



















NC CSRS Query


NC CSRS Query


NC CSRS Query

A

A

B

C

D


NC CSRS






NC CSRS Data Points



















CDC Guideline


CDC Guideline





CDC Guideline





CDC Guideline



Recommendation 1





Function




Recommendation 2




Recommendation 3




Discussion Topics















CDC Guideline



Recommendation 4



Recommendation 5






Recommendation 6




Recommendation 7














Tapering






CDC Guideline




Recommendation 8





At Risk Populations

bull Sleep apnea







Recommendation 9




Recommendation 10





bull Looking for

o Illicit drugs

o Prescribed drugs






Results






Patient Dismissal






Recommendation 11



Recommendation 12




TurnTheTide


compassionrdquo



Key Points













Mr H






Further Questioning







Other Information





Mr H






What Would You Do


Ms M





Further Questioning





Next Step


Mr E




2 Months Later




Now What


Resources












Questions


bull Call 18002539653



North Carolina





Program





Drug Take Back


Funding

Pharmaceuticals






NCMBrsquos Response













oUtilization









standards of care


supporting this



















NC CSRS Query


NC CSRS Query


NC CSRS Query

A

A

B

C

D


NC CSRS






NC CSRS Data Points



















CDC Guideline


CDC Guideline





CDC Guideline





CDC Guideline



Recommendation 1





Function




Recommendation 2




Recommendation 3




Discussion Topics















CDC Guideline



Recommendation 4



Recommendation 5






Recommendation 6




Recommendation 7














Tapering






CDC Guideline




Recommendation 8





At Risk Populations

bull Sleep apnea







Recommendation 9




Recommendation 10





bull Looking for

o Illicit drugs

o Prescribed drugs






Results






Patient Dismissal






Recommendation 11



Recommendation 12




TurnTheTide


compassionrdquo



Key Points













Mr H






Further Questioning







Other Information





Mr H






What Would You Do


Ms M





Further Questioning





Next Step


Mr E




2 Months Later




Now What


Resources












Questions


bull Call 18002539653






Program





Drug Take Back


Funding

Pharmaceuticals






NCMBrsquos Response













oUtilization









standards of care


supporting this



















NC CSRS Query


NC CSRS Query


NC CSRS Query

A

A

B

C

D


NC CSRS






NC CSRS Data Points



















CDC Guideline


CDC Guideline





CDC Guideline





CDC Guideline



Recommendation 1





Function




Recommendation 2




Recommendation 3




Discussion Topics















CDC Guideline



Recommendation 4



Recommendation 5






Recommendation 6




Recommendation 7














Tapering






CDC Guideline




Recommendation 8





At Risk Populations

bull Sleep apnea







Recommendation 9




Recommendation 10





bull Looking for

o Illicit drugs

o Prescribed drugs






Results






Patient Dismissal






Recommendation 11



Recommendation 12




TurnTheTide


compassionrdquo



Key Points













Mr H






Further Questioning







Other Information





Mr H






What Would You Do


Ms M





Further Questioning





Next Step


Mr E




2 Months Later




Now What


Resources












Questions


bull Call 18002539653



NCMBrsquos Response













oUtilization









standards of care


supporting this



















NC CSRS Query


NC CSRS Query


NC CSRS Query

A

A

B

C

D


NC CSRS






NC CSRS Data Points



















CDC Guideline


CDC Guideline





CDC Guideline





CDC Guideline



Recommendation 1





Function




Recommendation 2




Recommendation 3




Discussion Topics















CDC Guideline



Recommendation 4



Recommendation 5






Recommendation 6




Recommendation 7














Tapering






CDC Guideline




Recommendation 8





At Risk Populations

bull Sleep apnea







Recommendation 9




Recommendation 10





bull Looking for

o Illicit drugs

o Prescribed drugs






Results






Patient Dismissal






Recommendation 11



Recommendation 12




TurnTheTide


compassionrdquo



Key Points













Mr H






Further Questioning







Other Information





Mr H






What Would You Do


Ms M





Further Questioning





Next Step


Mr E




2 Months Later




Now What


Resources












Questions


bull Call 18002539653









oUtilization









standards of care


supporting this



















NC CSRS Query


NC CSRS Query


NC CSRS Query

A

A

B

C

D


NC CSRS






NC CSRS Data Points



















CDC Guideline


CDC Guideline





CDC Guideline





CDC Guideline



Recommendation 1





Function




Recommendation 2




Recommendation 3




Discussion Topics















CDC Guideline



Recommendation 4



Recommendation 5






Recommendation 6




Recommendation 7














Tapering






CDC Guideline




Recommendation 8





At Risk Populations

bull Sleep apnea







Recommendation 9




Recommendation 10





bull Looking for

o Illicit drugs

o Prescribed drugs






Results






Patient Dismissal






Recommendation 11



Recommendation 12




TurnTheTide


compassionrdquo



Key Points













Mr H






Further Questioning







Other Information





Mr H






What Would You Do


Ms M





Further Questioning





Next Step


Mr E




2 Months Later




Now What


Resources












Questions


bull Call 18002539653






oUtilization









standards of care


supporting this



















NC CSRS Query


NC CSRS Query


NC CSRS Query

A

A

B

C

D


NC CSRS






NC CSRS Data Points



















CDC Guideline


CDC Guideline





CDC Guideline





CDC Guideline



Recommendation 1





Function




Recommendation 2




Recommendation 3




Discussion Topics















CDC Guideline



Recommendation 4



Recommendation 5






Recommendation 6




Recommendation 7














Tapering






CDC Guideline




Recommendation 8





At Risk Populations

bull Sleep apnea







Recommendation 9




Recommendation 10





bull Looking for

o Illicit drugs

o Prescribed drugs






Results






Patient Dismissal






Recommendation 11



Recommendation 12




TurnTheTide


compassionrdquo



Key Points













Mr H






Further Questioning







Other Information





Mr H






What Would You Do


Ms M





Further Questioning





Next Step


Mr E




2 Months Later




Now What


Resources












Questions


bull Call 18002539653









standards of care


supporting this



















NC CSRS Query


NC CSRS Query


NC CSRS Query

A

A

B

C

D


NC CSRS






NC CSRS Data Points



















CDC Guideline


CDC Guideline





CDC Guideline





CDC Guideline



Recommendation 1





Function




Recommendation 2




Recommendation 3




Discussion Topics















CDC Guideline



Recommendation 4



Recommendation 5






Recommendation 6




Recommendation 7














Tapering






CDC Guideline




Recommendation 8





At Risk Populations

bull Sleep apnea







Recommendation 9




Recommendation 10





bull Looking for

o Illicit drugs

o Prescribed drugs






Results






Patient Dismissal






Recommendation 11



Recommendation 12




TurnTheTide


compassionrdquo



Key Points













Mr H






Further Questioning







Other Information





Mr H






What Would You Do


Ms M





Further Questioning





Next Step


Mr E




2 Months Later




Now What


Resources












Questions


bull Call 18002539653






standards of care


supporting this



















NC CSRS Query


NC CSRS Query


NC CSRS Query

A

A

B

C

D


NC CSRS






NC CSRS Data Points



















CDC Guideline


CDC Guideline





CDC Guideline





CDC Guideline



Recommendation 1





Function




Recommendation 2




Recommendation 3




Discussion Topics















CDC Guideline



Recommendation 4



Recommendation 5






Recommendation 6




Recommendation 7














Tapering






CDC Guideline




Recommendation 8





At Risk Populations

bull Sleep apnea







Recommendation 9




Recommendation 10





bull Looking for

o Illicit drugs

o Prescribed drugs






Results






Patient Dismissal






Recommendation 11



Recommendation 12




TurnTheTide


compassionrdquo



Key Points













Mr H






Further Questioning







Other Information





Mr H






What Would You Do


Ms M





Further Questioning





Next Step


Mr E




2 Months Later




Now What


Resources












Questions


bull Call 18002539653




















NC CSRS Query


NC CSRS Query


NC CSRS Query

A

A

B

C

D


NC CSRS






NC CSRS Data Points



















CDC Guideline


CDC Guideline





CDC Guideline





CDC Guideline



Recommendation 1





Function




Recommendation 2




Recommendation 3




Discussion Topics















CDC Guideline



Recommendation 4



Recommendation 5






Recommendation 6




Recommendation 7














Tapering






CDC Guideline




Recommendation 8





At Risk Populations

bull Sleep apnea







Recommendation 9




Recommendation 10





bull Looking for

o Illicit drugs

o Prescribed drugs






Results






Patient Dismissal






Recommendation 11



Recommendation 12




TurnTheTide


compassionrdquo



Key Points













Mr H






Further Questioning







Other Information





Mr H






What Would You Do


Ms M





Further Questioning





Next Step


Mr E




2 Months Later




Now What


Resources












Questions


bull Call 18002539653













NC CSRS Query


NC CSRS Query


NC CSRS Query

A

A

B

C

D


NC CSRS






NC CSRS Data Points



















CDC Guideline


CDC Guideline





CDC Guideline





CDC Guideline



Recommendation 1





Function




Recommendation 2




Recommendation 3




Discussion Topics















CDC Guideline



Recommendation 4



Recommendation 5






Recommendation 6




Recommendation 7














Tapering






CDC Guideline




Recommendation 8





At Risk Populations

bull Sleep apnea







Recommendation 9




Recommendation 10





bull Looking for

o Illicit drugs

o Prescribed drugs






Results






Patient Dismissal






Recommendation 11



Recommendation 12




TurnTheTide


compassionrdquo



Key Points













Mr H






Further Questioning







Other Information





Mr H






What Would You Do


Ms M





Further Questioning





Next Step


Mr E




2 Months Later




Now What


Resources












Questions


bull Call 18002539653










NC CSRS Query


NC CSRS Query


NC CSRS Query

A

A

B

C

D


NC CSRS






NC CSRS Data Points



















CDC Guideline


CDC Guideline





CDC Guideline





CDC Guideline



Recommendation 1





Function




Recommendation 2




Recommendation 3




Discussion Topics















CDC Guideline



Recommendation 4



Recommendation 5






Recommendation 6




Recommendation 7














Tapering






CDC Guideline




Recommendation 8





At Risk Populations

bull Sleep apnea







Recommendation 9




Recommendation 10





bull Looking for

o Illicit drugs

o Prescribed drugs






Results






Patient Dismissal






Recommendation 11



Recommendation 12




TurnTheTide


compassionrdquo



Key Points













Mr H






Further Questioning







Other Information





Mr H






What Would You Do


Ms M





Further Questioning





Next Step


Mr E




2 Months Later




Now What


Resources












Questions


bull Call 18002539653



NC CSRS Query


NC CSRS Query


NC CSRS Query

A

A

B

C

D


NC CSRS






NC CSRS Data Points



















CDC Guideline


CDC Guideline





CDC Guideline





CDC Guideline



Recommendation 1





Function




Recommendation 2




Recommendation 3




Discussion Topics















CDC Guideline



Recommendation 4



Recommendation 5






Recommendation 6




Recommendation 7














Tapering






CDC Guideline




Recommendation 8





At Risk Populations

bull Sleep apnea







Recommendation 9




Recommendation 10





bull Looking for

o Illicit drugs

o Prescribed drugs






Results






Patient Dismissal






Recommendation 11



Recommendation 12




TurnTheTide


compassionrdquo



Key Points













Mr H






Further Questioning







Other Information





Mr H






What Would You Do


Ms M





Further Questioning





Next Step


Mr E




2 Months Later




Now What


Resources












Questions


bull Call 18002539653



NC CSRS Query


NC CSRS Query

A

A

B

C

D


NC CSRS






NC CSRS Data Points



















CDC Guideline


CDC Guideline





CDC Guideline





CDC Guideline



Recommendation 1





Function




Recommendation 2




Recommendation 3




Discussion Topics















CDC Guideline



Recommendation 4



Recommendation 5






Recommendation 6




Recommendation 7














Tapering






CDC Guideline




Recommendation 8





At Risk Populations

bull Sleep apnea







Recommendation 9




Recommendation 10





bull Looking for

o Illicit drugs

o Prescribed drugs






Results






Patient Dismissal






Recommendation 11



Recommendation 12




TurnTheTide


compassionrdquo



Key Points













Mr H






Further Questioning







Other Information





Mr H






What Would You Do


Ms M





Further Questioning





Next Step


Mr E




2 Months Later




Now What


Resources












Questions


bull Call 18002539653



NC CSRS Query

A

A

B

C

D


NC CSRS






NC CSRS Data Points



















CDC Guideline


CDC Guideline





CDC Guideline





CDC Guideline



Recommendation 1





Function




Recommendation 2




Recommendation 3




Discussion Topics















CDC Guideline



Recommendation 4



Recommendation 5






Recommendation 6




Recommendation 7














Tapering






CDC Guideline




Recommendation 8





At Risk Populations

bull Sleep apnea







Recommendation 9




Recommendation 10





bull Looking for

o Illicit drugs

o Prescribed drugs






Results






Patient Dismissal






Recommendation 11



Recommendation 12




TurnTheTide


compassionrdquo



Key Points













Mr H






Further Questioning







Other Information





Mr H






What Would You Do


Ms M





Further Questioning





Next Step


Mr E




2 Months Later




Now What


Resources












Questions


bull Call 18002539653



NC CSRS






NC CSRS Data Points



















CDC Guideline


CDC Guideline





CDC Guideline





CDC Guideline



Recommendation 1





Function




Recommendation 2




Recommendation 3




Discussion Topics















CDC Guideline



Recommendation 4



Recommendation 5






Recommendation 6




Recommendation 7














Tapering






CDC Guideline




Recommendation 8





At Risk Populations

bull Sleep apnea







Recommendation 9




Recommendation 10





bull Looking for

o Illicit drugs

o Prescribed drugs






Results






Patient Dismissal






Recommendation 11



Recommendation 12




TurnTheTide


compassionrdquo



Key Points













Mr H






Further Questioning







Other Information





Mr H






What Would You Do


Ms M





Further Questioning





Next Step


Mr E




2 Months Later




Now What


Resources












Questions


bull Call 18002539653



NC CSRS Data Points



















CDC Guideline


CDC Guideline





CDC Guideline





CDC Guideline



Recommendation 1





Function




Recommendation 2




Recommendation 3




Discussion Topics















CDC Guideline



Recommendation 4



Recommendation 5






Recommendation 6




Recommendation 7














Tapering






CDC Guideline




Recommendation 8





At Risk Populations

bull Sleep apnea







Recommendation 9




Recommendation 10





bull Looking for

o Illicit drugs

o Prescribed drugs






Results






Patient Dismissal






Recommendation 11



Recommendation 12




TurnTheTide


compassionrdquo



Key Points













Mr H






Further Questioning







Other Information





Mr H






What Would You Do


Ms M





Further Questioning





Next Step


Mr E




2 Months Later




Now What


Resources












Questions


bull Call 18002539653
















CDC Guideline


CDC Guideline





CDC Guideline





CDC Guideline



Recommendation 1





Function




Recommendation 2




Recommendation 3




Discussion Topics















CDC Guideline



Recommendation 4



Recommendation 5






Recommendation 6




Recommendation 7














Tapering






CDC Guideline




Recommendation 8





At Risk Populations

bull Sleep apnea







Recommendation 9




Recommendation 10





bull Looking for

o Illicit drugs

o Prescribed drugs






Results






Patient Dismissal






Recommendation 11



Recommendation 12




TurnTheTide


compassionrdquo



Key Points













Mr H






Further Questioning







Other Information





Mr H






What Would You Do


Ms M





Further Questioning





Next Step


Mr E




2 Months Later




Now What


Resources












Questions


bull Call 18002539653










CDC Guideline


CDC Guideline





CDC Guideline





CDC Guideline



Recommendation 1





Function




Recommendation 2




Recommendation 3




Discussion Topics















CDC Guideline



Recommendation 4



Recommendation 5






Recommendation 6




Recommendation 7














Tapering






CDC Guideline




Recommendation 8





At Risk Populations

bull Sleep apnea







Recommendation 9




Recommendation 10





bull Looking for

o Illicit drugs

o Prescribed drugs






Results






Patient Dismissal






Recommendation 11



Recommendation 12




TurnTheTide


compassionrdquo



Key Points













Mr H






Further Questioning







Other Information





Mr H






What Would You Do


Ms M





Further Questioning





Next Step


Mr E




2 Months Later




Now What


Resources












Questions


bull Call 18002539653









CDC Guideline


CDC Guideline





CDC Guideline





CDC Guideline



Recommendation 1





Function




Recommendation 2




Recommendation 3




Discussion Topics















CDC Guideline



Recommendation 4



Recommendation 5






Recommendation 6




Recommendation 7














Tapering






CDC Guideline




Recommendation 8





At Risk Populations

bull Sleep apnea







Recommendation 9




Recommendation 10





bull Looking for

o Illicit drugs

o Prescribed drugs






Results






Patient Dismissal






Recommendation 11



Recommendation 12




TurnTheTide


compassionrdquo



Key Points













Mr H






Further Questioning







Other Information





Mr H






What Would You Do


Ms M





Further Questioning





Next Step


Mr E




2 Months Later




Now What


Resources












Questions


bull Call 18002539653








CDC Guideline


CDC Guideline





CDC Guideline





CDC Guideline



Recommendation 1





Function




Recommendation 2




Recommendation 3




Discussion Topics















CDC Guideline



Recommendation 4



Recommendation 5






Recommendation 6




Recommendation 7














Tapering






CDC Guideline




Recommendation 8





At Risk Populations

bull Sleep apnea







Recommendation 9




Recommendation 10





bull Looking for

o Illicit drugs

o Prescribed drugs






Results






Patient Dismissal






Recommendation 11



Recommendation 12




TurnTheTide


compassionrdquo



Key Points













Mr H






Further Questioning







Other Information





Mr H






What Would You Do


Ms M





Further Questioning





Next Step


Mr E




2 Months Later




Now What


Resources












Questions


bull Call 18002539653







CDC Guideline


CDC Guideline





CDC Guideline





CDC Guideline



Recommendation 1





Function




Recommendation 2




Recommendation 3




Discussion Topics















CDC Guideline



Recommendation 4



Recommendation 5






Recommendation 6




Recommendation 7














Tapering






CDC Guideline




Recommendation 8





At Risk Populations

bull Sleep apnea







Recommendation 9




Recommendation 10





bull Looking for

o Illicit drugs

o Prescribed drugs






Results






Patient Dismissal






Recommendation 11



Recommendation 12




TurnTheTide


compassionrdquo



Key Points













Mr H






Further Questioning







Other Information





Mr H






What Would You Do


Ms M





Further Questioning





Next Step


Mr E




2 Months Later




Now What


Resources












Questions


bull Call 18002539653




CDC Guideline


CDC Guideline





CDC Guideline





CDC Guideline



Recommendation 1





Function




Recommendation 2




Recommendation 3




Discussion Topics















CDC Guideline



Recommendation 4



Recommendation 5






Recommendation 6




Recommendation 7














Tapering






CDC Guideline




Recommendation 8





At Risk Populations

bull Sleep apnea







Recommendation 9




Recommendation 10





bull Looking for

o Illicit drugs

o Prescribed drugs






Results






Patient Dismissal






Recommendation 11



Recommendation 12




TurnTheTide


compassionrdquo



Key Points













Mr H






Further Questioning







Other Information





Mr H






What Would You Do


Ms M





Further Questioning





Next Step


Mr E




2 Months Later




Now What


Resources












Questions


bull Call 18002539653



CDC Guideline


CDC Guideline





CDC Guideline





CDC Guideline



Recommendation 1





Function




Recommendation 2




Recommendation 3




Discussion Topics















CDC Guideline



Recommendation 4



Recommendation 5






Recommendation 6




Recommendation 7














Tapering






CDC Guideline




Recommendation 8





At Risk Populations

bull Sleep apnea







Recommendation 9




Recommendation 10





bull Looking for

o Illicit drugs

o Prescribed drugs






Results






Patient Dismissal






Recommendation 11



Recommendation 12




TurnTheTide


compassionrdquo



Key Points













Mr H






Further Questioning







Other Information





Mr H






What Would You Do


Ms M





Further Questioning





Next Step


Mr E




2 Months Later




Now What


Resources












Questions


bull Call 18002539653



CDC Guideline





CDC Guideline





CDC Guideline



Recommendation 1





Function




Recommendation 2




Recommendation 3




Discussion Topics















CDC Guideline



Recommendation 4



Recommendation 5






Recommendation 6




Recommendation 7














Tapering






CDC Guideline




Recommendation 8





At Risk Populations

bull Sleep apnea







Recommendation 9




Recommendation 10





bull Looking for

o Illicit drugs

o Prescribed drugs






Results






Patient Dismissal






Recommendation 11



Recommendation 12




TurnTheTide


compassionrdquo



Key Points













Mr H






Further Questioning







Other Information





Mr H






What Would You Do


Ms M





Further Questioning





Next Step


Mr E




2 Months Later




Now What


Resources












Questions


bull Call 18002539653



CDC Guideline





CDC Guideline



Recommendation 1





Function




Recommendation 2




Recommendation 3




Discussion Topics















CDC Guideline



Recommendation 4



Recommendation 5






Recommendation 6




Recommendation 7














Tapering






CDC Guideline




Recommendation 8





At Risk Populations

bull Sleep apnea







Recommendation 9




Recommendation 10





bull Looking for

o Illicit drugs

o Prescribed drugs






Results






Patient Dismissal






Recommendation 11



Recommendation 12




TurnTheTide


compassionrdquo



Key Points













Mr H






Further Questioning







Other Information





Mr H






What Would You Do


Ms M





Further Questioning





Next Step


Mr E




2 Months Later




Now What


Resources












Questions


bull Call 18002539653



CDC Guideline



Recommendation 1





Function




Recommendation 2




Recommendation 3




Discussion Topics















CDC Guideline



Recommendation 4



Recommendation 5






Recommendation 6




Recommendation 7














Tapering






CDC Guideline




Recommendation 8





At Risk Populations

bull Sleep apnea







Recommendation 9




Recommendation 10





bull Looking for

o Illicit drugs

o Prescribed drugs






Results






Patient Dismissal






Recommendation 11



Recommendation 12




TurnTheTide


compassionrdquo



Key Points













Mr H






Further Questioning







Other Information





Mr H






What Would You Do


Ms M





Further Questioning





Next Step


Mr E




2 Months Later




Now What


Resources












Questions


bull Call 18002539653



Recommendation 1





Function




Recommendation 2




Recommendation 3




Discussion Topics















CDC Guideline



Recommendation 4



Recommendation 5






Recommendation 6




Recommendation 7














Tapering






CDC Guideline




Recommendation 8





At Risk Populations

bull Sleep apnea







Recommendation 9




Recommendation 10





bull Looking for

o Illicit drugs

o Prescribed drugs






Results






Patient Dismissal






Recommendation 11



Recommendation 12




TurnTheTide


compassionrdquo



Key Points













Mr H






Further Questioning







Other Information





Mr H






What Would You Do


Ms M





Further Questioning





Next Step


Mr E




2 Months Later




Now What


Resources












Questions


bull Call 18002539653



Function




Recommendation 2




Recommendation 3




Discussion Topics















CDC Guideline



Recommendation 4



Recommendation 5






Recommendation 6




Recommendation 7














Tapering






CDC Guideline




Recommendation 8





At Risk Populations

bull Sleep apnea







Recommendation 9




Recommendation 10





bull Looking for

o Illicit drugs

o Prescribed drugs






Results






Patient Dismissal






Recommendation 11



Recommendation 12




TurnTheTide


compassionrdquo



Key Points













Mr H






Further Questioning







Other Information





Mr H






What Would You Do


Ms M





Further Questioning





Next Step


Mr E




2 Months Later




Now What


Resources












Questions


bull Call 18002539653



Recommendation 2




Recommendation 3




Discussion Topics















CDC Guideline



Recommendation 4



Recommendation 5






Recommendation 6




Recommendation 7














Tapering






CDC Guideline




Recommendation 8





At Risk Populations

bull Sleep apnea







Recommendation 9




Recommendation 10





bull Looking for

o Illicit drugs

o Prescribed drugs






Results






Patient Dismissal






Recommendation 11



Recommendation 12




TurnTheTide


compassionrdquo



Key Points













Mr H






Further Questioning







Other Information





Mr H






What Would You Do


Ms M





Further Questioning





Next Step


Mr E




2 Months Later




Now What


Resources












Questions


bull Call 18002539653



Recommendation 3




Discussion Topics















CDC Guideline



Recommendation 4



Recommendation 5






Recommendation 6




Recommendation 7














Tapering






CDC Guideline




Recommendation 8





At Risk Populations

bull Sleep apnea







Recommendation 9




Recommendation 10





bull Looking for

o Illicit drugs

o Prescribed drugs






Results






Patient Dismissal






Recommendation 11



Recommendation 12




TurnTheTide


compassionrdquo



Key Points













Mr H






Further Questioning







Other Information





Mr H






What Would You Do


Ms M





Further Questioning





Next Step


Mr E




2 Months Later




Now What


Resources












Questions


bull Call 18002539653



Discussion Topics















CDC Guideline



Recommendation 4



Recommendation 5






Recommendation 6




Recommendation 7














Tapering






CDC Guideline




Recommendation 8





At Risk Populations

bull Sleep apnea







Recommendation 9




Recommendation 10





bull Looking for

o Illicit drugs

o Prescribed drugs






Results






Patient Dismissal






Recommendation 11



Recommendation 12




TurnTheTide


compassionrdquo



Key Points













Mr H






Further Questioning







Other Information





Mr H






What Would You Do


Ms M





Further Questioning





Next Step


Mr E




2 Months Later




Now What


Resources












Questions


bull Call 18002539653










CDC Guideline



Recommendation 4



Recommendation 5






Recommendation 6




Recommendation 7














Tapering






CDC Guideline




Recommendation 8





At Risk Populations

bull Sleep apnea







Recommendation 9




Recommendation 10





bull Looking for

o Illicit drugs

o Prescribed drugs






Results






Patient Dismissal






Recommendation 11



Recommendation 12




TurnTheTide


compassionrdquo



Key Points













Mr H






Further Questioning







Other Information





Mr H






What Would You Do


Ms M





Further Questioning





Next Step


Mr E




2 Months Later




Now What


Resources












Questions


bull Call 18002539653



CDC Guideline



Recommendation 4



Recommendation 5






Recommendation 6




Recommendation 7














Tapering






CDC Guideline




Recommendation 8





At Risk Populations

bull Sleep apnea







Recommendation 9




Recommendation 10





bull Looking for

o Illicit drugs

o Prescribed drugs






Results






Patient Dismissal






Recommendation 11



Recommendation 12




TurnTheTide


compassionrdquo



Key Points













Mr H






Further Questioning







Other Information





Mr H






What Would You Do


Ms M





Further Questioning





Next Step


Mr E




2 Months Later




Now What


Resources












Questions


bull Call 18002539653



Recommendation 4



Recommendation 5






Recommendation 6




Recommendation 7














Tapering






CDC Guideline




Recommendation 8





At Risk Populations

bull Sleep apnea







Recommendation 9




Recommendation 10





bull Looking for

o Illicit drugs

o Prescribed drugs






Results






Patient Dismissal






Recommendation 11



Recommendation 12




TurnTheTide


compassionrdquo



Key Points













Mr H






Further Questioning







Other Information





Mr H






What Would You Do


Ms M





Further Questioning





Next Step


Mr E




2 Months Later




Now What


Resources












Questions


bull Call 18002539653



Recommendation 5






Recommendation 6




Recommendation 7














Tapering






CDC Guideline




Recommendation 8





At Risk Populations

bull Sleep apnea







Recommendation 9




Recommendation 10





bull Looking for

o Illicit drugs

o Prescribed drugs






Results






Patient Dismissal






Recommendation 11



Recommendation 12




TurnTheTide


compassionrdquo



Key Points













Mr H






Further Questioning







Other Information





Mr H






What Would You Do


Ms M





Further Questioning





Next Step


Mr E




2 Months Later




Now What


Resources












Questions


bull Call 18002539653



Recommendation 6




Recommendation 7














Tapering






CDC Guideline




Recommendation 8





At Risk Populations

bull Sleep apnea







Recommendation 9




Recommendation 10





bull Looking for

o Illicit drugs

o Prescribed drugs






Results






Patient Dismissal






Recommendation 11



Recommendation 12




TurnTheTide


compassionrdquo



Key Points













Mr H






Further Questioning







Other Information





Mr H






What Would You Do


Ms M





Further Questioning





Next Step


Mr E




2 Months Later




Now What


Resources












Questions


bull Call 18002539653



Recommendation 7














Tapering






CDC Guideline




Recommendation 8





At Risk Populations

bull Sleep apnea







Recommendation 9




Recommendation 10





bull Looking for

o Illicit drugs

o Prescribed drugs






Results






Patient Dismissal






Recommendation 11



Recommendation 12




TurnTheTide


compassionrdquo



Key Points













Mr H






Further Questioning







Other Information





Mr H






What Would You Do


Ms M





Further Questioning





Next Step


Mr E




2 Months Later




Now What


Resources












Questions


bull Call 18002539653












Tapering






CDC Guideline




Recommendation 8





At Risk Populations

bull Sleep apnea







Recommendation 9




Recommendation 10





bull Looking for

o Illicit drugs

o Prescribed drugs






Results






Patient Dismissal






Recommendation 11



Recommendation 12




TurnTheTide


compassionrdquo



Key Points













Mr H






Further Questioning







Other Information





Mr H






What Would You Do


Ms M





Further Questioning





Next Step


Mr E




2 Months Later




Now What


Resources












Questions


bull Call 18002539653



Tapering






CDC Guideline




Recommendation 8





At Risk Populations

bull Sleep apnea







Recommendation 9




Recommendation 10





bull Looking for

o Illicit drugs

o Prescribed drugs






Results






Patient Dismissal






Recommendation 11



Recommendation 12




TurnTheTide


compassionrdquo



Key Points













Mr H






Further Questioning







Other Information





Mr H






What Would You Do


Ms M





Further Questioning





Next Step


Mr E




2 Months Later




Now What


Resources












Questions


bull Call 18002539653



CDC Guideline




Recommendation 8





At Risk Populations

bull Sleep apnea







Recommendation 9




Recommendation 10





bull Looking for

o Illicit drugs

o Prescribed drugs






Results






Patient Dismissal






Recommendation 11



Recommendation 12




TurnTheTide


compassionrdquo



Key Points













Mr H






Further Questioning







Other Information





Mr H






What Would You Do


Ms M





Further Questioning





Next Step


Mr E




2 Months Later




Now What


Resources












Questions


bull Call 18002539653



Recommendation 8





At Risk Populations

bull Sleep apnea







Recommendation 9




Recommendation 10





bull Looking for

o Illicit drugs

o Prescribed drugs






Results






Patient Dismissal






Recommendation 11



Recommendation 12




TurnTheTide


compassionrdquo



Key Points













Mr H






Further Questioning







Other Information





Mr H






What Would You Do


Ms M





Further Questioning





Next Step


Mr E




2 Months Later




Now What


Resources












Questions


bull Call 18002539653



At Risk Populations

bull Sleep apnea







Recommendation 9




Recommendation 10





bull Looking for

o Illicit drugs

o Prescribed drugs






Results






Patient Dismissal






Recommendation 11



Recommendation 12




TurnTheTide


compassionrdquo



Key Points













Mr H






Further Questioning







Other Information





Mr H






What Would You Do


Ms M





Further Questioning





Next Step


Mr E




2 Months Later




Now What


Resources












Questions


bull Call 18002539653



Recommendation 9




Recommendation 10





bull Looking for

o Illicit drugs

o Prescribed drugs






Results






Patient Dismissal






Recommendation 11



Recommendation 12




TurnTheTide


compassionrdquo



Key Points













Mr H






Further Questioning







Other Information





Mr H






What Would You Do


Ms M





Further Questioning





Next Step


Mr E




2 Months Later




Now What


Resources












Questions


bull Call 18002539653



Recommendation 10





bull Looking for

o Illicit drugs

o Prescribed drugs






Results






Patient Dismissal






Recommendation 11



Recommendation 12




TurnTheTide


compassionrdquo



Key Points













Mr H






Further Questioning







Other Information





Mr H






What Would You Do


Ms M





Further Questioning





Next Step


Mr E




2 Months Later




Now What


Resources












Questions


bull Call 18002539653




bull Looking for

o Illicit drugs

o Prescribed drugs






Results






Patient Dismissal






Recommendation 11



Recommendation 12




TurnTheTide


compassionrdquo



Key Points













Mr H






Further Questioning







Other Information





Mr H






What Would You Do


Ms M





Further Questioning





Next Step


Mr E




2 Months Later




Now What


Resources












Questions


bull Call 18002539653



Results






Patient Dismissal






Recommendation 11



Recommendation 12




TurnTheTide


compassionrdquo



Key Points













Mr H






Further Questioning







Other Information





Mr H






What Would You Do


Ms M





Further Questioning





Next Step


Mr E




2 Months Later




Now What


Resources












Questions


bull Call 18002539653



Patient Dismissal






Recommendation 11



Recommendation 12




TurnTheTide


compassionrdquo



Key Points













Mr H






Further Questioning







Other Information





Mr H






What Would You Do


Ms M





Further Questioning





Next Step


Mr E




2 Months Later




Now What


Resources












Questions


bull Call 18002539653



Recommendation 11



Recommendation 12




TurnTheTide


compassionrdquo



Key Points













Mr H






Further Questioning







Other Information





Mr H






What Would You Do


Ms M





Further Questioning





Next Step


Mr E




2 Months Later




Now What


Resources












Questions


bull Call 18002539653



Recommendation 12




TurnTheTide


compassionrdquo



Key Points













Mr H






Further Questioning







Other Information





Mr H






What Would You Do


Ms M





Further Questioning





Next Step


Mr E




2 Months Later




Now What


Resources












Questions


bull Call 18002539653




TurnTheTide


compassionrdquo



Key Points













Mr H






Further Questioning







Other Information





Mr H






What Would You Do


Ms M





Further Questioning





Next Step


Mr E




2 Months Later




Now What


Resources












Questions


bull Call 18002539653



TurnTheTide


compassionrdquo



Key Points













Mr H






Further Questioning







Other Information





Mr H






What Would You Do


Ms M





Further Questioning





Next Step


Mr E




2 Months Later




Now What


Resources












Questions


bull Call 18002539653



Key Points













Mr H






Further Questioning







Other Information





Mr H






What Would You Do


Ms M





Further Questioning





Next Step


Mr E




2 Months Later




Now What


Resources












Questions


bull Call 18002539653






Mr H






Further Questioning







Other Information





Mr H






What Would You Do


Ms M





Further Questioning





Next Step


Mr E




2 Months Later




Now What


Resources












Questions


bull Call 18002539653



Mr H






Further Questioning







Other Information





Mr H






What Would You Do


Ms M





Further Questioning





Next Step


Mr E




2 Months Later




Now What


Resources












Questions


bull Call 18002539653



Further Questioning







Other Information





Mr H






What Would You Do


Ms M





Further Questioning





Next Step


Mr E




2 Months Later




Now What


Resources












Questions


bull Call 18002539653



Other Information





Mr H






What Would You Do


Ms M





Further Questioning





Next Step


Mr E




2 Months Later




Now What


Resources












Questions


bull Call 18002539653



Mr H






What Would You Do


Ms M





Further Questioning





Next Step


Mr E




2 Months Later




Now What


Resources












Questions


bull Call 18002539653



What Would You Do


Ms M





Further Questioning





Next Step


Mr E




2 Months Later




Now What


Resources












Questions


bull Call 18002539653



Ms M





Further Questioning





Next Step


Mr E




2 Months Later




Now What


Resources












Questions


bull Call 18002539653



Further Questioning





Next Step


Mr E




2 Months Later




Now What


Resources












Questions


bull Call 18002539653



Next Step


Mr E




2 Months Later




Now What


Resources












Questions


bull Call 18002539653



Mr E




2 Months Later




Now What


Resources












Questions


bull Call 18002539653



2 Months Later




Now What


Resources












Questions


bull Call 18002539653



Now What


Resources












Questions


bull Call 18002539653



Resources












Questions


bull Call 18002539653










Questions


bull Call 18002539653



Questions


bull Call 18002539653


Documents

Controlled Substances Prescribing: What Every Provider