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 warranted by a diagnosis, 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 have been met. They cannot override these practice policies, negotiate, or make exceptions. We will never guarantee CDS prior to completing an evaluation, regardless of past history or evaluations.

We do not prescribe more than one controlled substance per patient and cannot accept or manage patients 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, or even legal substances if they may pose a risk in treatment). Patients receiving CDS from this practice must be seen at least once per month for the first 6 months, and every 2 months for the following 6 months, even if they have been on these medications previously. After stabilizing on these medications at this practice for at least one full year, a provider may consider increasing up to never more than a maximum of 90 days at a time (if and when, appropriate). Even for long-term patients, CDS are never prescribed without an appointment under any circumstances; if an appointment is missed, another appointment must be attended before medication will be prescribed, without exception.

 

  • Stimulants: For those with a legitimate ADHD diagnosis who depend on these medications, we want to ensure they have appropriate access. At the same time, we are keenly aware that individuals without ADHD attempt to inappropriately obtain these medications and have safeguards in place to prevent this. While we may prescribe stimulants in the treatment of ADHD this will only be done 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. We must also agree with the diagnosis after conducting our own evaluation. Anyone receiving stimulants from this practice must be able to pass a drug screen. 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 a limited number of situations due to serious health and safety risks. Long-term use is often counterproductive and can lead to worsening baseline symptoms instead of improvement.
  • 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 (in-person) 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.