​Fewer and fewer doctors’ offices are now willing to prescribe opioids. At OMG, we continue to prescribe opioids, but we can do so ONLY IF we can show that the medications we prescribe are being taken properly. Making sure medications are being taken properly is known as compliance monitoring and it is at the core of what we do. We use several tools, but there are three main ones.
 
Pill counts
How we do pill counts: 

• We know how many pills you were prescribed and when you picked them up
• We know how many pills you are allowed to take in a day
• We know how many days have passed since your last refill
• We calculate how many pills you should have remaining

Please bring your pills with you at every visit for pill counting. We calculate your pill count to the accuracy of ONE pill. You can return with more pills than we think you should have, but not less. For example, there is no problem if we calculated that you should return with 5 pills, but you brought back 12 pills – this is not a problem because you do not have to take all the pills we prescribe. But you cannot bring back fewer pills because that means you have overtaken. If we think you should be bringing in 5 pills, but you return with only 4 pills, you are short by one pill. 
 
What we do when you are short depends on how many you are short by, how often you are short, the results of your drug tests, etc. However, we do not replace missing pills. Therefore, if you are short by 3 pills, your next prescription will have 3 pills less to make up for the missing pills. Also, be aware that insurance companies do not pay for early fills if you overtake.
 
Drug testing
Drug testing is a crucial part of compliance monitoring. We do not report your drug tests to anyone without your express permission, including probation officers, DCS workers, or even family. We do not do drug tests to “catch” bad things – you will never be dismissed no matter what we find on drug testing.
We ask you to declare any drugs or medications you have taken in the past 3 days.
We use 2 kinds of drug testing: screening tests that give us immediate results but are less accurate, and confirmatory tests that are highly accurate but takes several days to come back.
Please always arrive for your appointment ready to provide a urine sample.
Please understand that the collection technicians who collect your samples do NOT work for OMG but work for the Lab
 
Prescription Database
All controlled drugs prescribed to you should show up in the Indiana Prescription Drug Monitoring Program database, known as INSPECT. We check this record before every appointment. We also have the ability to check the record of neighboring states. 

Help us to document that you are taking your medications properly. That allows us to minimize the number of your appointments and drug tests, while maximizing flexibility in your treatment plan.
 
We know that taking pills properly isn’t always easy. That is why we have come up with ways to help you. Please see our 2-Bottle Method. 
We try to make our compliance monitoring less intrusive in your lives, so we devised the Virtual Pill Count.
 
If you are taking medications properly, we will help you prove your compliance.
If you struggle to take pills correctly, we will help you improve your compliance.
If you are abusing or misusing your pills, we will help you control your problem, rather than make your problem worse by giving you more medications to abuse.
 
We promise in writing in our Patients' Bill of Rights that we do not dismiss or fire patients for any medical reasons. We would not even fire a patient if we found cocaine in his/her urine. The reason is that a patient with cocaine in his/her urine has already shown he/she likely has access to street drugs. Dismissing this patient would likely push this patient to the cocaine dealer for pain relief, possibly leading to heroin. Of course we would have to change how we treat this patient’s pain.