Opioid medications are strong pain medications, often called narcotics.
Examples Include: Norco, Vicodin, Percocet, Oxycontin, Fentanyl, and Morphine.

The Center for Disease Control and the State of Michigan’s Department of Health and Human Services has responded to the nation’s opioid epidemic by releasing several tools and requirements that Orthopaedic Associates of Muskegon has utilized to create our prescribing guidelines.

There has been an increasing number of opioid-related overdoses and death. These are usually associated with higher doses of opioids, but even relatively low dosages (20-50 morphine milligram equivalents (MME) per day, which is about the same as taking Norco 10-325mg three times per day) increases risk.

Higher dosages also haven’t been shown to reduce pain over the long term.

Our office guidelines are as follows:

• An Informed Consent form will be reviewed and signed prior to obtaining a prescription.
• Opioid/Narcotic prescriptions for acute pain can only be given for a 7-day supply within a 7-day period, in accordance with state law.
• Orthopedic surgeons and Sports Medicine doctors do not treat chronic pain and will not prescribe opioid/narcotic medications for chronic pain.
• Physical Medicine and Rehab (PM&R) doctors may treat for chronic pain and will work with you to manage your pain to allow you to meet your functional goals.
• If you are currently under a “pain contract” with another physician or receiving pain medication from another office or doctor (including the ER), you must notify us of this. Failure to do so will limit our ability to prescribe any medications. It is unsafe for multiple doctors to prescribe pain medications at once.
• After a fracture, opioids/narcotics will be prescribed for up to 2 weeks after the fracture.
• After surgery, opioids/narcotics are typically prescribed for 2 weeks.
  • Severe postoperative pain typically decreases drastically within 2-3 days of surgery and is gone after 2 weeks, due to our bodies natural painkillers (endorphins)
  • You should only take the medication as needed and work to reduce the amount and frequency of medication over those 2 weeks.
  • There will be some expected post-operative soreness and this should be discussed prior to surgery.
  • It is very important to reduce and eliminate narcotic pain medication for 2 weeks prior to surgery, so it will be more effective after surgery.
• We are always available to discuss alternative treatment options for your pain and will work with you on those options.

At your first visit you will be asked to sign a form that acknowledges receiving our Notice of Privacy Practices, as well as giving consent to treat, share information if necessary, to leave you a voicemail or send you a text notification, or prescribe to a pharmacy when needed. An additional form will be presented enabling us to bill your insurance and acknowledging your financial responsibility for the payment of services. The receptionist can provide you with a paper copy of the Notice of Privacy Practices when you arrive.

You can review the Notice of Privacy Practices here: