Important Office Policies

Controlled Substances

Effective April 2023

Adult ADHD

For years, family practice journals have recommended that adult attention-deficit/hyperactivity disorder (ADHD) be handled by specialists (psychiatry or neurology), not family doctors, for multiple and complex reasons. After many discussions, our office is now on board with this recommendation. We are happy to give appropriate referrals for this diagnosis.

Senior Medications

The Beers List was developed in 1991 for use by doctors and clinicians to improve the care of patients 65 years and older. This list includes medications that should be avoided in all elderly patients, if at all possible, and also lists potentially harmful medication interactions. The most relevant of these medications includes addictive and controlled medications (for pain or anxiety) but also includes certain anti-inflammatory and diabetic medications. Our office tries to stay very mindful of the Beers List and advises changes to medication regimens accordingly. Please note that insurance companies see the family doctor as the “quarterback” of a patient’s care team and rely on us to adjust and stop medications, even if they have been recommended or ordered by specialists.

Other Controlled And/Or Addictive Medications

Aside from our patients that are 65 years and older, we recognize that patients at any age should not be on routine medications that are addictive or controlled substances. These may include pain medications, muscle relaxers, and anxiety medications. Our office stays very mindful of this, advising changes to medication regimens accordingly, and making appropriate referrals to specialists. Again, it is noted that insurance companies see the family doctor as the quarterback of a patient’s care, and therefore, will send us recommendations to adjust or stop medications, even ordered by specialists.

Medical Marijuana

Medical marijuana certifications will only be done for patients of the practice, and only if we see this therapy as an appropriate adjunct to other medical modalities. There can be negative effects of long-term marijuana use, including permanent IQ loss, worsening depression or anxiety, decreased athletic performance, impaired driving, decreased motivation, and above all, addiction. Research has shown that long-term effects heavily depend on how the patient is using medical marijuana. Use of creams and tinctures have been shown to be the most efficient at delivering relief with minimal side effects. The HCIM does not recommend vaping or smoking marijuana to ease symptoms as any potential benefit is outweighed by potential damage to the lungs.

In addition, we have found that the diagnosis of anxiety may be better served by seeing a psychology or psychiatry specialist, going to counseling, considering lifestyle changes, prescribing supplements, and prescribing medications. We have stricter guidelines for obtaining a medical card, since we are a family practice office focused on treatments that have the highest efficacy.

We recognize that these policies may cause concern in some of our patients that have relied on these medicines in the past. Because of these policies, our practice may not be a good fit for everyone. The Health Center for Integrative Medicine’s mission is to provide comprehensive healthcare services in a way that integrates the best of conventional and alternative medicine.