Controlled substances are drugs that are highly monitored and restricted on a state and/or federal level. These restrictions, this monitoring, is for patients’ protection. The drugs that fall under this heading can be habit-forming, addictive, can result in overdose deaths or are sold/traded on the street or abused like illicit illegal drugs. (An explanation of controlled medications in Texas can be located at

These controlled Rx’s are almost always electronically prescribed now. On rare occasion we may require the old green CII paper Rx that we used to exclusively have to use. These have to be picked up in person at our office. A picture ID may be required to pick up the paper Rx.

The job of electronically refilling class II controlled meds is a time-consuming process each month. For several classes of controlled substance additional refills cannot be added to a Rx so they have to be prescribed anew each month. Also, for many of these Rx’s it is now law that we check the Texas PMP Aware website every time we refill a prescription in those classes. Yes, every time, every month, every patient. Therefore, PLEASE BE SPECIFIC WITH THE PHARMACY YOU WISH TO USE WHEN REQUESTING REFILLS, and PLEASE NOTIFY US 3-4 DAYS BEFORE YOU ARE OUT OF MEDS THAT YOU NEED A REFILL. We appreciate this as it cuts down on repeat jobs of resending Rx’s multiple times each month and it prevents “emergency refills” at the last minute. The later affects our patient, as we DO NOT DO CONTROLLED MED REFILLS AFTER HOURS OR ON WEEKENDS, and we ask for 24-48 hours to complete a requested refill.

**Due to the increased workload and liability involved with every opiate prescription that is written, we are not writing opiate prescriptions (Rx pain pills) for NEW patients who take them on a daily, chronic basis. Any new patient on opiate prescriptions will have to see a pain management specialist for their medication/chronic pain treatment. We also will not write “temporary” opiate prescriptions for new patients who are between pain management doctors**

Routine follow-up office visits with the doctor or nurse practitioner will be required every 3 to 6 months. Every patient on a controlled substance medication will be required to see Dr. McWilliams at least once a year but interim follow up visits may be done with a nurse practitioner. Dosage changes or problems with medication will require more frequent follow-up visits. Patients deemed at higher risk will require more frequent follow-ups which will be determined by the doctor on a patient-specific basis.

These things bear repeating:

We ask for 24-48 hours (1-2 business days) to fulfill your refill request. If refills are requested on a Friday, we do not guarantee you will have it by the weekend. So, please anticipate running out of medication and request refills accordingly. This has always been our policy, but we have always strived to exceed your expectations in this area of service and have succeeded in getting refills ready on the same day most of the time. That may prove progressively more difficult with the increased amount of work involved with CII Rx’s that we will be processing on a daily basis. Please take special note of this policy and be patient with our staff.

Controlled substance medications will not be refilled after hours or on weekends.

Patients may be asked to sign a Controlled Substance Contract with the doctor/clinic in order to receive certain medications.

Prescriptions will be written for a 30, 60, or 90 day supply, depending on patient preference or insurance cost restrictions/benefits.

Early refills will not be given for any reason. This is not up for debate or discussion.

If you lose your CII paper Rx before filling it, there will be a $10 charge for rewriting it.

If you lose your pills or they are stolen, an early refill cannot and will not be sent. It is the patient’s responsibility to take care of their controlled substance medication. Not up for debate or discussion.

Dosage changes/adjustments require an office visit. These requests will not be done by phone or portal message.

All of these rules and regulations are put into place to protect the honest people in our communities and to protect your doctor or practitioner’s license and reputation. Stone Creek Family Medicine is happy to adjust to the increased workload that these regulations create as it means stemming the flow of narcotic Rx drugs onto our streets. Accidental overdose deaths from prescription narcotic drugs outnumber overdose deaths from illicit street drugs by a staggering margin, and hydrocodone products account for a significant share of those deaths. This is a good thing for our state as a whole, so please try to keep that in mind as we make this transition.


Dr. McWilliams and the SCFM Staff