The Southeastern Spine Institute

  • Only your physician at the Southeastern Spine Institute will prescribe narcotic medication for you. 
  • It is our legal obligation to contact DHEC if we find you are getting medication from any other providers. 
  • You agree not to ask for narcotic medications from any other doctor without the knowledge and assent of your physician at The Southeastern Spine Institute. 
  • You agree to provide regular urine samples for drug screens. 
  • Positive tests for any Illegal substances, or narcotics not prescribed by your pain doctor, may result in your dismissal and referral elsewhere for substance abuse evaluation and management. 
  • No prescriptions will be refilled early. No prescriptions will be refilled if you lose, destroy, or have any of your medication stolen.
  • Prescription refills will be authorized only during regular office hours. If you want to refill your prescription, call two working days in advance of the renewal date. 
  • Patients taking chronic narcotics should NOT drink alcohol. 
  • No prescription dosage changes will be made without an office visit. Only one pharmacy may be used. 
  • You agree to comply fully with all aspects of your treatment program including behavioral medicine (psychology/psychiatry) and physical therapy, if recommended. Failure to do so may result in discontinuation of your medication and referral to another provider or treatment center. 
  • Successful pain management includes using multiple interventions, including active participation in regular exercise and use of psychological coping strategies. 
  • Failure to follow the prescribed treatment plan including medication, therapy, etc., may result in discontinuation of medications and/or referral to another provider or treatment center. 
  • I agree to follow these guidelines that have been fully explained to me. All of my questions and concerns regarding treatment have been adequately answered. 
  • I give permission to my pain doctor to contact my other healthcare providers, for the purposes of sharing information concerning my situation, as is deemed necessary for coordinated, high quality care. 
  • If I do not follow these guidelines fully, my doctor may stop opioid treatment and refer me elsewhere for care.
  • A copy of this document will be given to me, if requested.

Side Effects:

Opioids (narcotics) may cause drowsiness that can be worsened with alcohol, benzodiazepines, and other sedating medications. Use care when driving and operating machinery. An overdose can cause severe side effects, even death.

Other common, usually temporary, side effects include nausea, itching, and sweating. Psychological depression and lowered testosterone levels (in men) may also occur. Sleep apnea, if present, may be worsened by opioids. Constipation commonly occurs, and often does not improve with time. It is impossible to predict opioid side effects in any individual patient. Having side effects on one opioid does not necessarily mean there will be side effects on another opioid.

You must take opioids only as directed. Federal law prohibits giving this medication to anyone else. Physical dependence will develop with regular use, but does not by itself indicate addiction; this means that a withdrawal syndrome will develop if you stop your medication abruptly. Tolerance may develop to the pain relieving effects of opioids; this means that the pain relief may decrease over time, but in chronic pain states this usually occurs slowly, if at all.

Not all pain conditions respond to opioids. Some pain may only be partially responsive to opioid therapy. Total elimination of pain is an unrealistic goal. Increasing dosages may indicate that opioids are not effective or that there is an underlying problem with addiction or psychological dependence. Discontinuation of opioid medications may need to be done under these circumstances: not enough pain relief, persistent side effects, not achieving goals of opioid treatment (such as improvement in function), problematic dosage increases, or inability to comply with the treatment agreement.