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I am currently working as NP in a detox unit. The facility is a CARF and we receive all patients. I have always used the state wide monitoring website as a data tool when getting to know the patients and trying to determine what their goals are for treatment of SUD. I am discovering many of them are receiving pain medications from pain management providers and they are selling their medications, trading for other drugs or as payment for a place to stay. I am not allowed to notify the pain management providers because that would violate the patients rights. They come to the facility where I work with the expectation of receiving subutex, hoping to stay for a "detox" until they can fill their next pain medication prescription. Many are not forthcoming and are caught off guard when I inform them I'm aware they just received 120 oxycodone from Dr. John Doe and I suggest they call their provider for an early refill. Of course they do not want to do that. These patients are smart enough to pass urine tests. The one patient in particular finally admitted he only uses a small amount of the pain medicine and his urine was positive for meth in addition to opiate. He gives the medications to his mother so they can pay the rent.  How do we combat the amount of opiates on the streets if we are not allowed to share information among professionals? 

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