The same policy every patient signs at onboarding, here in full so that nothing about how we prescribe is a surprise.
Cognitive Works provides medication management based on independent diagnostic evaluation and ongoing clinical judgment. The prescribing of controlled substances, including but not limited to stimulant medications, benzodiazepines, and certain sleep or pain medications, is not automatic, is not guaranteed, and is determined solely by the treating psychiatrist on the basis of medical necessity, safety, applicable laws and regulations, and an individualized assessment of risk.
Controlled substances carry significant risks, including misuse, dependence, diversion, tolerance, withdrawal, and adverse medical or psychiatric effects. The decision to start, continue, change, taper or stop any controlled medication rests with the treating psychiatrist, who weighs those risks against the benefit for each patient.
As a condition of receiving a controlled substance, you may be asked to take part in monitoring and safety measures. Depending on the medication and your situation, these may include:
If required monitoring is not completed, the medication may be modified or discontinued, and continuation of treatment may be affected.
Early refills, replacement prescriptions for lost or stolen medication, and dose escalations are not routinely provided. Each is considered individually, at the sole discretion of the treating psychiatrist. Evidence of misuse, diversion, falsified information, non-adherence, unsafe use, or violation of treatment expectations may result in dose reduction, discontinuation of the medication, or termination of the treatment relationship, consistent with applicable law and ethical standards.
When a controlled medication is prescribed, it is prescribed as part of a comprehensive treatment plan. It may be reduced or discontinued at any time if, in the psychiatrist’s clinical judgment, the risks outweigh the benefits or continued prescribing is no longer clinically appropriate. When that is the decision, the taper is planned with you; nothing is stopped abruptly.
Not automatically. We review it with you at the first visit, with the records and the state prescription monitoring program, and decide together whether to continue, adjust or taper it. Nothing is stopped abruptly.
Early refills, replacements for lost or stolen medication, and dose increases are not routinely provided. Each is considered individually by the treating psychiatrist.
Depending on the medication and your situation: review of prescription monitoring data, scheduled or random toxicology screening, pill counts, pharmacy verification, and coordination with your other clinicians.
Yes. Controlled medications are part of a comprehensive treatment plan and may be reduced or discontinued when, in the psychiatrist’s judgment, the risks outweigh the benefits. When that happens we plan the taper with you.