Fishtown Medicine prescribes controlled substances like ADHD stimulants, short-term sleep aids, and gabapentinoids using clear safety guardrails. We use the state Prescription Drug Monitoring Program (PDMP), require regular follow-ups, do not provide early refills, and do not prescribe Schedule II opioids for chronic pain.
TL;DR: Controlled substances, like stimulants for ADHD or short-term sleep aids, need close clinical oversight to keep you safe and prevent dependence. At Fishtown Medicine, we use clear, transparent guardrails to protect your health while making sure you get the support you need without judgment.
This policy explains exactly which medications are covered, how we evaluate need, how refills work, and what monitoring looks like. The goal is to keep care predictable for you and safe for everyone.
Table of Contents
- What are Controlled Substances?
- Our Prescribing Framework
- Safety Monitoring and Refills
- Guidelines from the Clinic
- Common Questions
What are Controlled Substances?
Controlled substances are medications regulated by federal and state law because they have a potential for misuse or physical dependence. Examples include:
- Stimulants: Adderall, Vyvanse, Ritalin (for ADHD).
- Benzodiazepines: Ativan, Xanax, Valium (for acute anxiety or specific procedures).
- Sleep Aids: Ambien, Lunesta.
- Gabapentinoids: Gabapentin, Pregabalin.
Note: Fishtown Medicine does not prescribe Schedule II opioids for chronic pain management.
Our Prescribing Framework
We never rush into prescribing a controlled substance. We assess the whole picture first.
- Medical Necessity: Documented through a thorough diagnostic evaluation.
- Safer Alternatives First: We always explore integrated strategies or non-controlled options before moving to more intensive therapeutics.
- PDMP Review: We use the state Prescription Drug Monitoring Program (PDMP), a database that tracks controlled prescriptions across providers, to make sure your history is consistent and safe.
- Clinical Audit: We review outside records from previous providers to maintain continuity of care.
Safety Monitoring and Refills
To keep care safe and sustainable, we follow clear monitoring and refill rules.
- Periodic Follow-ups: Regular consults (telehealth or in-person) are required for all patients on controlled medications.
- No Early Refills: For safety and legal compliance, we do not provide early refills for lost, stolen, or misplaced medications.
- Urine Drug Screening: May be requested for specific higher-risk medications to confirm therapeutic consistency.
- Pill Counts and Pharmacy Verification: For select higher-risk situations, we may ask for a pill count or verify fill history with your pharmacy. We explain the reason before we ask.
Guidelines from the Clinic
Actionable Steps for Medication Safety
Build a sustainable strategy.
- Request Records: If you are joining from another practice, have your records sent to us through your patient portal so we can review them before the first visit.
- Monitor Your Response: Use simple energy and focus notes in the app to track how your medications affect your daily life.
- Tapering Discussions: If you feel you are becoming dependent or the meds are losing their effect, start a conversation. We do supervised, gradual tapering.
- Plan Refills Early: Request refills at least 5 business days before you run out, so we have time to schedule any required follow-up.
Dr. Ash is a board-certified internal medicine physician specializing in preventive medicine and healthspan optimization at Fishtown Medicine in Philadelphia.
Frequently Asked Questions
Common Questions
Ready when you are
Dr. Ash reads every intake himself, and answers questions personally - usually within a few hours.
