Controlled Dangerous Substances (CDS) Policy

This section only applies to Controlled Dangerous Substances (CDS). All other appropriate prescription medications can be prescribed without any special restrictions.

Baltimore Psychiatry may prescribe limited CDS in the treatment of certain psychiatric disorders when medically appropriate and the benefits outweigh the risk. This information is provided so prospective patients can determine if we may be able to meet their treatment needs only. The decision to prescribe or not prescribe CDS is still always at the discretion of the provider. However, they can only do so when all policy criteria has been met. They cannot override these practice policies, negotiate, or make exceptions. We will never guarantee CDS prior to completing an evaluation. We do not prescribe more than one controlled substance per patient and cannot accept or manage patients requesting or taking more than one controlled substance. We never prescribe dosages higher than the FDA has approved for the indicated diagnosis. Anyone receiving CDS from this practice must be able to pass a drug screen (demonstrating no illegal substances are being used, including prescription medications that were not prescribed). Patients receiving CDS from this practice must be seen at least once per month for the first 90 days, even if they have been on these medications previously. After this, a provider may consider increasing up to a maximum of no more than 90 days at a time, if and when appropriate.

• Stimulants: We want to make access to medication as convenient and hassle-free as possible for those with legitimate ADHD. At the same time, we are keenly aware of the high volume of individuals without ADHD who attempt to inappropriately obtain these medications. We may prescribe stimulants in the treatment of ADHD but only after a trial of a non-controlled substance has been found ineffective. If you have taken medication for ADHD previously and would like to receive immediate consideration for stimulant use, we will require that you have your medical records sent to us prior to considering the prescribing of a stimulant and may require drug screening. We must also agree with the diagnosis. It is unsafe to prescribe these medications at all for those with a history of certain medical and psychiatric disorders. Those with significant cardiovascular risk factors may be able to take these medications with careful monitoring but we are not able to prescribe for these individuals in this practice setting.
• Benzodiazepines and barbiturates: We never prescribe these medications at this practice under any circumstances. These medications are generally only indicated for short-term use in crisis situations. Long-term use is generally counterproductive as it will alter brain chemistry and contribute to worsening baseline symptoms. They also carry serious safety and health risks. 
• Hypnotic sedatives/sleep aids: We often prescribe NON-controlled substance sleep aids. Before considering the use of short-term controlled substance sleep aids, we must have record of a completed sleep study. Non-controlled substance sleep aids must have proven ineffective and the medication must be deemed to have a highly favorable benefit to risk ratio.