How do you approach patients establishing care on high doses of opioids or benzodiazepines who need refills, but you are not comfortable continuing them on their current doses?

How do you approach patients establishing care on high doses of controlled substances who need refills, but you are not comfortable continuing them on their current doses? Select all that apply to your approach:

• Check a UDS at the initial visit
• Complete a controlled substance agreement
• Refill at current dose with close follow up
• Initiate taper at first visit
• Provide short courses only to ensure close follow up
• Set clear expectations of goals for tapering
• Set clear expectations for goals of therapy
• Refuse to fill at first visit unless there is concern for withdrawal
• Other