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How we handle controlled substances and tightly regulated medications

We use controlled substances only when truly needed — here’s how we work together to keep their use safe, clear, and aligned.

Updated over a week ago

Medication Safety at Fishtown Medicine

Some medications carry higher risks and are tightly regulated — including sedatives, stimulants, and medications with potential for misuse or harm.

At Fishtown Medicine, we take medication safety seriously and follow strict standards to ensure your care stays safe, clear, and aligned with your goals.

We do not prescribe narcotics

We do not prescribe narcotic pain medications, including:

  • Opioids such as oxycodone, hydrocodone, morphine, tramadol, or fentanyl

  • High-risk combinations involving multiple controlled substances

If you require these medications, we recommend working with a pain management or addiction specialist. We’re happy to coordinate care once that relationship is in place.

Why this matters

Controlled substances can be helpful, but they also carry risks: tolerance, dependence, overdose, and dangerous interactions.

Even non-narcotic controlled medications (like stimulants or benzodiazepines) are prescribed cautiously, reviewed regularly, and used only when the benefits clearly outweigh the risks.

What you agree to:

  • Share all medications, supplements, and substances you're using

  • Use one pharmacy for controlled prescriptions

  • Store medications safely and never share them

  • Avoid alcohol or unapproved substances while on controlled medications

  • Complete labs, pill counts, or drug screens when requested

  • Carry naloxone (Narcan) if you’re prescribed an opioid

  • Seek emergency help if you or someone nearby shows signs of overdose or distress


What we commit to:

  • Explain the purpose, risks, and alternatives before prescribing

  • Use the lowest effective dose for the shortest appropriate time

  • Monitor your response and adjust when needed

  • Review the Prescription Drug Monitoring Program (PDMP) regularly

  • Coordinate care with your other providers and pharmacy

  • Taper or discontinue medication if risks outweigh benefits

Refills and follow-up

Refills for controlled substances are not automatic. They require:

  • Follow-up visits

  • Relevant labs or drug screening

  • No red flags on the PDMP or screening tests

  • Continued agreement on safety and benefit

When a medication may be stopped

We may reduce or stop a controlled medication if:

  • You request a taper

  • It’s no longer helping or safe

  • There are concerning results on labs or screening

  • You appear impaired or unsafe

  • You do not respect the care agreement

If you’re unsure whether a medication is part of this policy, or want to better understand the risks and alternatives, let us know. We’re here to have that conversation — without pressure, judgment, or shortcuts.

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