QUESTION: Hello, I am in an unlicensed state and I cannot prescribe medications, can I still take patients off of their medications they no longer want to take?
ANSWER: Basically the issue is less if you can Rx the med and more if with what you can Rx you can handle the Dx. For example if you have a HTN patient and can d/c their Rx with herbs, and the HTN is well controlled it doesn’t matter whether you could Rx the HTN med or not. The practical issue is that in tapering the Anxiety meds you often have a LONG taper and LOTS of work to do to get them off – during which time someone needs to Rx them. In those cases you have to have another prescriber. It is similar to what I used to teach in pharm about Bipolar 1 patients – regardless of whether you can Rx the med or not, another prescriber is key to accountability and good management in many cases. So – I have had good luck working with the other prescriber IF they (a) want the pt off the med and (b) believe I can help. We just have 3-way consent to share info and a plan everyone knows which relates to what you are going to do and how the drug taper should go. In the absence of that (or another prescriber who will take the Rx over) you are stuck when their Rx runs out and you don’t have any way to get them the lower doses in the taper.