How would you handle a fellow PA asking you to prescribe a painkiller for back pain?

How would you handle a fellow PA asking you to prescribe a painkiller for back pain?

• A. Explain you cannot prescribe opioids to friends and discuss potential opioid abuse
• B. Prescribe the medication to help a colleague
• C. Ignore the request and change the subject
• D. Refer them to another physician without discussion

Answer: (A)

The key idea here is maintaining professional boundaries and safe prescribing practices when someone asks you to prescribe a controlled substance. Opioids carry real risks of misuse, dependence, and harm, so prescribing them to a friend or colleague creates a dual relationship that can cloud judgment and violate ethical and legal guidelines. Choosing to explain that you cannot prescribe opioids to friends and to discuss the potential for opioid abuse is the best approach because it directly upholds professional standards, protects both you and the patient from inappropriate prescribing, and opens a safe path forward. It shows you take safety seriously, you’re keeping the patient’s health as the priority, and you’re encouraging proper medical evaluation and discussion of safer or alternative pain-management options. Other responses sidestep or undermine those boundaries: prescribing to a colleague bypasses core safety and professional boundaries; ignoring the request ignores an important safety issue; and referring someone without discussion may be abrupt and doesn’t address the risks or offer a constructive route. The chosen approach balances clear boundary-setting with patient safety and professional integrity.

The key idea here is maintaining professional boundaries and safe prescribing practices when someone asks you to prescribe a controlled substance. Opioids carry real risks of misuse, dependence, and harm, so prescribing them to a friend or colleague creates a dual relationship that can cloud judgment and violate ethical and legal guidelines.

Choosing to explain that you cannot prescribe opioids to friends and to discuss the potential for opioid abuse is the best approach because it directly upholds professional standards, protects both you and the patient from inappropriate prescribing, and opens a safe path forward. It shows you take safety seriously, you’re keeping the patient’s health as the priority, and you’re encouraging proper medical evaluation and discussion of safer or alternative pain-management options.

Other responses sidestep or undermine those boundaries: prescribing to a colleague bypasses core safety and professional boundaries; ignoring the request ignores an important safety issue; and referring someone without discussion may be abrupt and doesn’t address the risks or offer a constructive route. The chosen approach balances clear boundary-setting with patient safety and professional integrity.