Opioid Prescribing Risks in the COVID-19 Era: What Clinicians Need To Know
I joined the Affiliated Monitors Expert Podcast Series for a conversation about one of the hardest parts of frontline practice in recent years: prescribing opioids for chronic pain during and after the COVID-19 pandemic.
You can listen here:
The Affiliated Monitors Expert Podcast Series – Navigating the Risks of Prescribing Opioids for Chronic Pain in the COVID-19 Era
In this episode, I speak alongside:
- Jesse Caplan, an attorney with deep experience in healthcare regulation
- Deb Waugh, a licensed clinical social worker who designs and runs physician competency evaluations and training
Together, we look at opioid prescribing from medical, legal, and compliance angles.
Why This Conversation Still Matters
COVID-19 changed how many clinicians cared for patients in pain:
- Rapid expansion of telehealth
- Disrupted in-person visits and monitoring
- Rising stress, isolation, and mental health needs
- Ongoing scrutiny from regulators and payers
Clinicians had to balance access to needed pain control with real risks of misuse, diversion, and regulatory action. That tension has not gone away.
My Role On The Episode
I joined as a physician who:
- Is board certified in Internal Medicine
- Has many years of outpatient experience in Boston
- Reviews cases as an expert on opioid prescribing standard of care
On the podcast, I focus on what reasonable, careful opioid prescribing looks like in real life, not in theory. That includes how context matters when care shifted quickly during the pandemic.
We talk about:
- How boards and regulators look at standard of care in this setting
- What patterns often trigger concern
- How documentation can either protect or expose you
Key Risks For Prescribers
We walk through common risk areas, such as:
- Starting or escalating opioids without clear functional goals
- Poor documentation of risk-benefit discussions
- Inconsistent use of prescription monitoring programs
- Limited follow up or monitoring, especially with telehealth
- Prescribing outside your comfort zone or specialty
- Not addressing warning signs of misuse or diversion
We also discuss the difference between a single judgment call that could go either way, and a pattern of practice that is more likely to be viewed as substandard.
What Boards And Monitors Look For
With Deb and Jesse, we discuss what happens when a licensee comes under review:
- How competency evaluations are structured
- What regulators and monitors expect to see in remediation
- How education and practice changes can reduce risk going forward
The goal is not to scare clinicians. It is to make clear what is realistic, and what steps can protect both patients and prescribers.
Practical Steps You Can Take Now
If you prescribe opioids for chronic pain, this episode can help you think through concrete changes such as:
- Tightening your intake and risk screening process
- Using treatment agreements with real follow through
- Standardizing documentation of goals, monitoring, and taper plans
- Building a plan for higher risk patients, including when to involve specialists
- Preparing in advance for a possible chart review or audit
These steps protect your patients and also protect your license.
Listen And Share
You can listen to the full conversation here:
The Affiliated Monitors Expert Podcast Series – Navigating the Risks of Prescribing Opioids for Chronic Pain in the COVID-19 Era
If you are a clinician, medical leader, or compliance officer who wants support around opioid prescribing policies, education, or case review, this episode is a useful starting point for internal discussion.