Start Talking! program to reduce medication abuse.

     Start Talking! is a program from the State of Ohio to prevent over the counter and prescription medication abuse by children. It is aimed at reducing the misuse or abuse of these medications by informing the public and taking steps to ensure that parents and families are advised about these potential issues before filling a prescription. The website is here at Start Talking! Ohio.
     I think this program is terrific and it has a very real impact on our practice. When a prescription for an opioid is written for a child (often a prescription strength cough medication for pre-teens and teenagers), a form needs to be signed by the prescribing doctor and the parent. This form then is brought to the pharmacy where the prescription will be filled. We are required to do this step with the opioids now -- the doctor could lose their prescribing privileges for controlled medications if these steps are not followed.
     This above scenario most often applies to one of the hydrocodone-containing cough medications that are prescription-only, including Histussin, Hycodan, and generics (hydrocodone-homotropine). We used to be allowed to call the medication into the pharmacy. We cannot call this medication into the pharmacy any longer. If we do write the prescription in the office, it needs to be hand delivered by the parent to the pharmacy, along side the signed Start Talking! form stating that we have discussed the safe use of these medications as they can be misused and abused, and therefore are potentially dangerous. The forms are to be signed by the doctor and the parent dropping off the prescription.
     Although there are pain medications that contain the opioid hydrocodone (along with acetaminophen), such as Vicodin, it is very rare for pediatricians to prescribe these medications -- I can recall only prescribing them a handful of times in 21 years of being a pediatrician.
     I realize this is burden to families who "follow the rules" and the medications do not become misused or abused. However, the reality is we will need to follow these guidelines for the foreseeable future.