Prescriptions
At Big Tree we try to help you save money on health care anytime we can. For example, we purchase medications from the same wholesalers that pharmacies use and then sell it to our patients at cost ($59/month plan, $44/month plan), or give it to them as a part of the plan (=FREE in most business plans). “At Cost” prices for $59/month patient range from $0.30-$5.00/month (or per course for antibiotics), call or email for an exact price. Patients not a part of a monthly plan pay $5+cost for medications. We reserve the right to change the below list as medication prices change and as medication supplies change, so consider it representative. You can call/email for exact prices. Patients with Free medications also get free shipping (or delivery) if they live outside of Boone County.
| Name (We are only allowed to dispense medications that we prescribe). You must also pay for the office visit or be on a monthly plan). BOLD = FREE on Group plans | Generic for | Approximate Per month or per use cost is less than: | Cost for patients not on a monthly plan | Common price (derived from local, published prices) |
| ACYCLOVIR 400mg/1 | Zovirax 400 mg | $1.50 | $6.50 | $11.00 |
| ACYCLOVIR 800mg/1 | Zovirax 800 mg | $3.00 | $8.00 | $17.82 |
| ALBUTEROL SULFATE 2.5mg/3mL – 60 VIAL in 1 CARTON | Proventil | $2.80 | $7.80 | $22.00 |
| ALLOPURINOL 300mg/1 | Zyloprim | $7.00 | $12.00 | $22.00 |
| AMIODARONE HYDROCHLORIDE 200mg/1 | Cordarone 200 mg | $3.40 | $8.40 | $27.00 |
| AMITRIPTYLINE HYDROCHLORIDE 10mg/1 | Elavil 10 mg | $2.00 | $7.00 | $12.20 |
| AMITRIPTYLINE HYDROCHLORIDE 25mg/1 | Elavil 25 mg | $3.40 | $8.40 | $15.00 |
| AMITRIPTYLINE HYDROCHLORIDE 50mg/1 | Elavil | $6.00 | $11.00 | $21.00 |
| AMLODIPINE BESYLATE 10mg/1 | Norvasc | $0.50 | $5.50 | $11.00 |
| AMLODIPINE BESYLATE 5mg/1 | NORVASC 5 MG | $0.50 | $5.50 | $11.00 |
| AMOXICILLIN; CLAVULANATE POTASSIUM 875mg/1; 125mg/1 | Augmentin 875/125 MG | $5.10 | $10.10 | $33.00 |
| AMOXICILLIN 500mg/1 | Amoxil | $1.20 | $6.20 | $15.00 |
| ARIPIPRAZOLE 15mg/1 | ABILIFY 15 MG | $9.70 | $14.70 | $295.00 |
| ARIPIPRAZOLE 30mg/1 | Abilify 30 mg | $13.90 | $18.90 | $416.00 |
| ARIPIPRAZOLE 5mg/1 | Abilify | $9.60 | $14.60 | $253.00 |
| Armour Thyroid (THYROID, PORCINE) 120mg/1 | Armour Thyroid 2Gr | $43.00 | $48.00 | $56.00 |
| Armour Thyroid (THYROID, PORCINE) 15mg/1 | Armour thyroid 1/4 | $19.70 | $24.70 | $28.00 |
| ATENOLOL 100mg/1 | Tenormin | $3.70 | $8.70 | $10.00 |
| ATENOLOL 25mg/1 | TENORMIN 25 MG | $1.70 | $6.70 | $10.00 |
| ATORVASTATIN CALCIUM 10mg/1 | LIPITOR 10 MG | $1.20 | $6.20 | $35.30 |
| ATORVASTATIN CALCIUM 20mg/1 | Lipitor 20 mg | $1.80 | $6.80 | $36.84 |
| ATORVASTATIN CALCIUM 40mg/1 | Lipitor 40 mg | $3.50 | $8.50 | $18.43 |
| AZELASTINE HYDROCHLORIDE 137ug/.137mL | Astelin NS | $11.40 | $16.40 | $39.52 |
| AZITHROMYCIN MONOHYDRATE 250mg/1 | Zithromax | $1.80 | $6.80 | $21.00 |
| BACLOFEN 10mg/1 | Baclofen 10 mg | $4.90 | $9.90 | $28.00 |
| BENZONATATE 100mg/1 | Tessalon Perles | $3.50 | $8.50 | $21.00 |
| BETAMETHASONE DIPROPIONATE 0.5mg/g – 1 TUBE in 1 CARTON | Diprolene AF | $8.00 | $13.00 | $120.00 |
| BUPROPION HYDROCHLORIDE 300mg/1 | Wellbutrin XL | $10.30 | $15.30 | $35.00 |
| BUPROPION HYDROCHLORIDE 150mg/1 | Wellbutrin SR 150 mg | $2.40 | $7.40 | $41.00 |
| BUSPIRONE HYDROCHLORIDE 30mg/1 | BUSPAR 30 MG | $9.00 | $14.00 | $67.00 |
| BUSPIRONE HYDROCHLORIDE 7.5mg/1 | BUSPAR 7.5 MG | $12.00 | $17.00 | $63.00 |
| CARBIDOPA; LEVODOPA 25mg/1; 100mg/1 | Sinemet | $3.00 | $8.00 | $23.00 |
| CARVEDILOL 12.5mg/1 | Coreg | $0.60 | $5.60 | $13.93 |
| CARVEDILOL 25mg/1 | Coreg 25 mg | $0.90 | $5.90 | $17.00 |
| CEFADROXIL 500mg/1 | Duricef 500 mg | $1.10 | $6.10 | $18.00 |
| CEFDINIR 300mg/1 | OMNICEF 300 MG | $3.00 | $8.00 | $59.00 |
| CELECOXIB 100mg/1 | Celebrex 100 mg | $5.60 | $10.60 | $25.94 |
| CELECOXIB 200mg/1 | Celebrex 200 mg | $5.60 | $10.60 | $64.58 |
| CEPHALEXIN 500mg/1 | Keflex 500 mg | $3.10 | $8.10 | $11.85 |
| CIPROFLOXACIN HYDROCHLORIDE 250mg/1 | CIPRO 250MG | $0.70 | $5.70 | $25.00 |
| CIPROFLOXACIN HYDROCHLORIDE 500mg/1 | Cipro 500 mg | $0.70 | $5.70 | $25.00 |
| CIPROFLOXACIN HYDROCHLORIDE 750mg/1 | Cipro 750 mg | $1.60 | $6.60 | $21.00 |
| CITALOPRAM HYDROBROMIDE 20mg/1 | Celexa 20 mg | $0.60 | $5.60 | $10.00 |
| CITALOPRAM HYDROBROMIDE 40mg/1 | Celexa 40 mg | $0.90 | $5.90 | $11.00 |
| CLINDAMYCIN HYDROCHLORIDE 300mg/1 | Cleocin 300 mg | $8.70 | $13.70 | $30.00 |
| CLOPIDOGREL BISULFATE 75mg/1 | Plavix | $1.70 | $6.70 | $21.00 |
| CYCLOBENZAPRINE HYDROCHLORIDE 10mg/1 | FLEXERIL 10 MG | $0.80 | $5.80 | $10.00 |
| DILTIAZEM HYDROCHLORIDE 300mg/1 | Tiazac | $14.90 | $19.90 | $26.00 |
| DIVALPROEX SODIUM 500mg/1 | Depakote | $2.80 | $7.80 | $84.00 |
| DOXYCYCLINE HYCLATE 100mg/1 | Vibramycin | $2.10 | $7.10 | $21.00 |
| DULOXETINE HYDROCHLORIDE 30mg/1 | CYMBALTA 30 MG | $4.40 | $9.40 | $52.00 |
| DULOXETINE HYDROCHLORIDE 60mg/1 | Cymbalta 60 mg | $4.50 | $9.50 | $54.00 |
| ESCITALOPRAM OXALATE 10mg/1 | Lexapro 10 mg | $1.20 | $6.20 | $49.00 |
| ESCITALOPRAM OXALATE 20mg/1 | LEXAPRO 20 MG | $1.50 | $6.50 | $49.00 |
| ESOMEPRAZOLE MAGNESIUM 40mg/1 | NEXIUM 40 MG | $7.60 | $12.60 | $47.00 |
| ESTRADIOL 0.025mg/d | Vivelle dot 0.025 MG | $7.00 | $12.00 | $85.00 |
| ESTRADIOL 1mg/1 | Estrace 1 mg | $3.60 | $8.60 | $12.00 |
| ESTRADIOL 2mg/1 | Estrace | $5.20 | $10.20 | $14.00 |
| FAMCICLOVIR 500mg/1 | Famvir | $28.50 | $33.50 | $91.00 |
| FINASTERIDE 5mg/1 | PROSCAR 5 MG | $3.80 | $8.80 | $21.00 |
| FLUCONAZOLE 150mg/1 | DIFLUCAN 150 MG | $1.10 | $6.10 | $12.48 |
| FLUOXETINE HYDROCHLORIDE 10mg/1 | Prozac | $0.60 | $5.60 | $15.00 |
| FLUOXETINE HYDROCHLORIDE 20mg/1 | Prozac | $0.60 | $5.60 | $15.00 |
| FLUOXETINE HYDROCHLORIDE 40mg/1 | Prozac | $2.20 | $7.20 | $17.00 |
| FLUTICASONE PROPIONATE 50ug/1 | Flonase nasal spray | $6.10 | $11.10 | $16.00 |
| FUROSEMIDE 40mg/1 | Lasix | $3.10 | $8.10 | $10.00 |
| GABAPENTIN 300mg/1 | Gabapentin | $2.70 | $7.70 | $15.00 |
| GABAPENTIN 400mg/1 | Neurontin | $3.30 | $8.30 | $15.00 |
| Gianvi | Yaz 3MG/0.02MG | $28.40 | $33.40 | $36.00 |
| GLIMEPIRIDE 2mg/1 | Amaryl | $4.80 | $9.80 | $14.61 |
| GLIMEPIRIDE 4mg/1 | Amaryl | $4.90 | $9.90 | $25.00 |
| GLIPIZIDE 10mg/1 | Glucotrol 10 mg | $2.00 | $7.00 | $11.63 |
| GLIPIZIDE 5mg/1 | $1.80 | $6.80 | $10.72 | |
| GLYBURIDE; METFORMIN HYDROCHLORIDE 5mg/1; 500mg/1 | Glucovance | $3.00 | $8.00 | $22.58 |
| HYDROCHLOROTHIAZIDE 12.5mg/1 | MICROZIDE 12.5 MG | $0.90 | $5.90 | $9.58 |
| HYDROCHLOROTHIAZIDE 25mg/1 | HYDRODIURIL 25 MG | $0.20 | $5.20 | $9.58 |
| HYDROCHLOROTHIAZIDE 50mg/1 | Hydroduril | $0.60 | $5.60 | $9.58 |
| HYDROXYZINE PAMOATE 50mg/1 | Vistaril | $1.90 | $6.90 | $10.35 |
| HYDROXYZINE PAMOATE 50mg/1 | Vistaril 50 mg | $2.60 | $7.60 | $10.35 |
| INDOMETHACIN 25mg/1 | Indocin 25 mg | $2.40 | $7.40 | $9.43 |
| IPRATROPIUM BROMIDE; ALBUTEROL SULFATE 0.5mg/3mL; 3mg/3mL | Duoneb | $5.20 | $10.20 | $25.64 |
| ISOSORBIDE MONONITRATE 30mg/1 | Imdur | $3.20 | $8.20 | $16.21 |
| ISOSORBIDE MONONITRATE 60mg/1 | Imdur 60 mg | $3.20 | $8.20 | $16.21 |
| KETOROLAC TROMETHAMINE 60mg/2mL | Toradol | $2.40 | $7.40 |
NA |
| KETOTIFEN FUMARATE 0.35mg/mL | Zaditor | $9.30 | $14.30 | $15.95 |
| LAMOTRIGINE 100mg/1 | Lamictal 100 mg | $1.60 | $6.60 | $44.48 |
| LAMOTRIGINE 25mg/1 | Lamictal | $0.70 | $5.70 | $37.18 |
| LETROZOLE 2.5mg/1 | Femara | $4.10 | $9.10 | $136.16 |
| LEVOFLOXACIN 500mg/1 | Levaquin | $1.40 | $6.40 | $53.40 |
| Lipitor (Atorvastatin) 40mg | Lipitor | $3.30 | $8.30 | $45.37 |
| LISINOPRIL; HYDROCHLOROTHIAZIDE 10mg/1; 12.5mg/1 | Zestoretic | $0.70 | $5.70 | $10.17 |
| HYDROCHLOROTHIAZIDE; LISINOPRIL 12.5mg/1; 10mg/1 | $0.90 | $5.90 | $10.17 | |
| LISINOPRIL 10mg/1 | Zestril 10 mg | $0.40 | $5.40 | $6.31 |
| LISINOPRIL 20mg/1 | ZESTRIL 20 MG | $0.70 | $5.70 | $6.31 |
| LISINOPRIL 40mg/1 | zestril 40 mg | $0.90 | $5.90 | $6.31 |
| LISINOPRIL 5mg/1 | Zestril | $0.30 | $5.30 | $6.31 |
| LITHIUM CARBONATE 150mg/1 | ESKALITH 150 MG | $2.80 | $7.80 | $11.41 |
| LITHIUM CARBONATE 300mg/1 | ESKALITH 300 MG | $2.10 | $7.10 | $11.41 |
| LITHIUM CARBONATE 600mg/1 | Eskalith 600 mg | $4.80 | $9.80 | $11.41 |
| LITHIUM CARBONATE 600mg/1 | ESKALITH 600 MG | $6.90 | $11.90 | $11.41 |
| LORATADINE 10mg/1 (300 count) | CLARITIN 10 MG (DISPENSE BY BOTTLE OF 300) | $12.30 | $17.30 | $47.86 |
| LOSARTAN POTASSIUM; HYDROCHLOROTHIAZIDE 50mg/1; 12.5mg/1 | Hyzaar 50/12.5 | $1.60 | $6.60 | $24.11 |
| LOSARTAN POTASSIUM 100mg/1 | Cozaar | $1.40 | $6.40 | $22.81 |
| LOSARTAN POTASSIUM 100mg/1 | Cozaar 100 mg | $2.00 | $7.00 | $22.81 |
| LOSARTAN POTASSIUM 50mg/1 | Cozaar | $2.10 | $7.10 | $22.81 |
| LOVASTATIN 20mg/1 | $1.30 | $6.30 | $16.97 | |
| LOVASTATIN 40mg/1 | Mevacor | $1.80 | $6.80 | $26.04 |
| Meclizine HCL 12.5 mg 12.5mg/1 | Bonine 12.5 mg | $0.80 | $5.80 | $11.34 |
| MELOXICAM 15mg/1 | Mobic 15 mg | $0.60 | $5.60 | $13.51 |
| MELOXICAM 7.5mg/1 | Mobic | $0.50 | $5.50 | $18.42 |
| METFORMIN HYDROCHLORIDE 1000mg/1 | Glucophage 1000 mg | $1.20 | $6.20 | $21.47 |
| METFORMIN HYDROCHLORIDE XR 500mg/1 | GLUCOPHAGE XR 500 MG | $1.80 | $6.80 | $14.24 |
| METOPROLOL SUCCINATE 100mg/1 | Toprol XL 100 mg | $7.00 | $12.00 | $24.40 |
| METOPROLOL SUCCINATE 25mg/1 | Toprol XL 25 mg | $4.30 | $9.30 | $16.09 |
| METOPROLOL SUCCINATE 50mg/1 | Toprol XL | $4.30 | $9.30 | $13.04 |
| METOPROLOL TARTRATE 50mg/1 | Lopressor 50 mg | $0.90 | $5.90 | $13.04 |
| METRONIDAZOLE 500mg/1 | Flagyl | $5.90 | $10.90 | $11.00 |
| MONTELUKAST SODIUM 10mg/1 | SINGULAIR 10 MG | $1.80 | $6.80 | $70.47 |
| MUPIROCIN 20mg/g – 1 TUBE | BACTROBAN OINT 2% | $4.30 | $9.30 | $19.26 |
| NALTREXONE HYDROCHLORIDE 50mg/1 | Revia 50 mg | $18.30 | $23.30 | $43.55 |
| NAPROXEN 500mg/1 | Naprosyn 500 mg | $1.50 | $6.50 | $11.33 |
| Nebulizer mini | $25.00 | $30.00 |
NA |
|
| NICOTINE 14mg/24h | Habitrol Trans Patch 14 mg | $52.50 | $57.50 | $84.00 |
| NICOTINE 21mg/24h | Habitrol Trans Patch 21 mg | $52.50 | $57.50 | $112.00 |
| NIFEDIPINE 30mg/1 | PROCARDIA XL 30 MG | $4.40 | $9.40 | $19.05 |
| Nitrofurantoin (monohydrate/macrocrystals) 75mg/1; 25mg/1 | Macrobid 100 mg | $5.40 | $10.40 | $21.06 |
| NITROGLYCERIN 0.4mg/1 | NITROSTAT 0.4 MG | $8.00 | $13.00 | $17.52 |
| Norgestimate and Ethinyl Estradiol | Ortho Tri Cyclen (BIRTH CONTROL) | $4.30 | $9.30 | $19.82 |
| OLMESARTAN MEDOXOMIL 40mg/1 | Benicar 40 mg | $2.10 | $7.10 | $64.80 |
| OMEPRAZOLE 20mg/1 | Prilosec 20 mg | $1.30 | $6.30 | $62.93 |
| ONDANSETRON HYDROCHLORIDE 4mg/1 | Zofran 4 mg | $0.80 | $5.80 | $46.79 |
| OXYBUTYNIN CHLORIDE 10mg/1 | Ditropan XL 10 mg | $10.90 | $15.90 | $35.93 |
| PANTOPRAZOLE SODIUM 40mg/1 | Protonix | $2.70 | $7.70 | $30.50 |
| PAROXETINE HYDROCHLORIDE HEMIHYDRATE 20mg/1 | PAXIL 20 MG | $2.00 | $7.00 | $19.08 |
| PRAVASTATIN SODIUM 20mg/1 | PRAVACHOL 20 MG | $2.60 | $7.60 | $14.00 |
| PRAZOSIN HYDROCHLORIDE 1mg/1 | Minipress | $12.20 | $17.20 | $16.26 |
| PREDNISONE 20mg/1 | PREDNISONE 20 MG | $3.30 | $8.30 | $6.90 |
| Prilosec (Omeprazole DR) 40mg | Prilosec 40 mg | $3.40 | $8.40 | $62.93 |
| PROGESTERONE 100mg/1 | Prometrium 100 mg | $18.90 | $23.90 | $25.33 |
| PROPRANOLOL HYDROCHLORIDE 60mg/1 | INDERAL LA 60 MG | $15.90 | $20.90 | $28.56 |
| QUETIAPINE FUMARATE 25mg/1 | Seroquel 25 mg | $1.20 | $6.20 | $42.98 |
| QUETIAPINE FUMARATE 100mg/1 | Seroquel | $1.60 | $6.60 | $66.60 |
| QUETIAPINE FUMARATE 200mg/1 | Seroquel 200 mg | $2.40 | $7.40 | $117.60 |
| QUETIAPINE FUMARATE 300mg/1 | Seroquel 300 mg | $4.10 | $9.10 | $151.50 |
| QUINAPRIL HYDROCHLORIDE 40mg/1 | ACCUPRIL 40 MG | $2.90 | $7.90 | $16.72 |
| RAMIPRIL 10mg/1 | ALTACE 10 MG | $1.20 | $6.20 | $26.12 |
| RANITIDINE HYDROCHLORIDE 300mg/1 | Zantac 300mg | $3.10 | $8.10 | $33.12 |
| RISPERIDONE 2mg/1 | Risperdal | $2.50 | $7.50 | $63.72 |
| RISPERIDONE 4mg/1 | Risperdal | $2.40 | $7.40 | $95.40 |
| RIZATRIPTAN BENZOATE 10mg/1 (9 pills) | Maxalt 10 mg | $17.40 | $22.40 | $94.50 |
| ROSUVASTATIN CALCIUM 10mg/1 | CRESTOR 10 MG | $4.80 | $9.80 | $84.00 |
| ROSUVASTATIN CALCIUM 20mg/1 | Crestor 20mg | $6.50 | $11.50 | $84.00 |
| ROSUVASTATIN CALCIUM 40mg/1 | CRESTOR 40 MG | $10.10 | $15.10 | $85.00 |
| SERTRALINE HYDROCHLORIDE 25mg/1 | Zoloft | $1.40 | $6.40 | $17.93 |
| SERTRALINE HYDROCHLORIDE 50mg/1 | ZOLOFT 50 MG | $1.60 | $6.60 | $17.54 |
| SERTRALINE HYDROCHLORIDE 100mg/1 | Zoloft | $2.30 | $7.30 | $17.10 |
| SILDENAFIL CITRATE 20mg/1 (30 pills) | Revatio 20 mg | $5.00 | $10.00 | $19.00 |
| SIMVASTATIN 20mg/1 | Zocor 20 mg | $1.40 | $6.40 | $14.00 |
| SIMVASTATIN 40mg/1 | Zocor | $0.90 | $5.90 | $17.00 |
| Spironolactone 100mg/1 | Aldactone 100 mg | $9.50 | $14.50 | $13.64 |
| Spironolactone 50mg/1 | Aldactone 50 mg | $6.50 | $11.50 | $13.64 |
| SULFAMETHOXAZOLE; TRIMETHOPRIM 800mg/1; 160mg/1 | Septra | $0.80 | $5.80 | $11.41 |
| SUMATRIPTAN SUCCINATE 25mg/1 (9 pills) | Imitrex 25 mg | $6.30 | $11.30 | $72.72 |
| SUMATRIPTAN SUCCINATE 6mg/.5mL injection | Imitrex Inj | $21.50 | $26.50 | $121.00 |
| Tadalafil 5mg x 30 pills | Cialis | $7.32 | $12.32 | $108.45 |
| TAMSULOSIN HYDROCHLORIDE 0.4mg/1 | Flomax | $2.60 | $7.60 | $20.29 |
| TERBINAFINE HYDROCHLORIDE 250mg/1 | Lamisil | $3.00 | $8.00 | $31.17 |
| TIZANIDINE HYDROCHLORIDE 4mg/1 | Zanaflex 4 mg | $2.60 | $7.60 | $16.42 |
| TOPIRAMATE 100mg/1 | Topamax | $1.60 | $6.60 | $97.44 |
| TOPIRAMATE 200mg/1 | Topamax 200 mg | $2.10 | $7.10 | $120.68 |
| TOPIRAMATE 25mg/1 | Topamax 25 mg | $0.60 | $5.60 | $46.95 |
| TOPIRAMATE 50mg/1 | TOPAMAX 50 MG | $1.20 | $6.20 | $61.64 |
| TRAZODONE HYDROCHLORIDE 100mg/1 | DESYREL 100 MG | $2.10 | $7.10 | $13.14 |
| TRAZODONE HYDROCHLORIDE 150mg/1 | Desyrel 150 mg | $3.70 | $8.70 | $19.46 |
| TRAZODONE HYDROCHLORIDE 50mg/1 | Desyrel | $1.20 | $6.20 | $12.49 |
| Tri-Lo-Sprintec (Norgestimate and Ethinyl Estradiol) | ORTHO TRI CYCLEN LO | $6.10 | $11.10 | $29.00 |
| TRIAMCINOLONE ACETONIDE 0.25mg/g 15 g in 1 TUBE | Aristocort/kenalog | $2.00 | $7.00 | $11.00 |
| TRIAMCINOLONE ACETONIDE 1mg/g – 30 g in 1 TUBE (67877-251-30) | Aristocort/ Kenalog | $4.90 | $9.90 | $13.00 |
| VALACYCLOVIR HYDROCHLORIDE 500mg/1 | VALTREX 500 MG | $6.70 | $11.70 | $36.00 |
| VENLAFAXINE HYDROCHLORIDE 150mg/1 | Effexor XR 150 mg | $4.30 | $9.30 | $350.00 |
| VENLAFAXINE HYDROCHLORIDE 37.5mg/1 | EFFEXOR XR 37.5 MG | $3.10 | $8.10 | $31.00 |
| VENLAFAXINE HYDROCHLORIDE 75mg/1 | Effexor XR 75mg | $4.00 | $9.00 | $28.85 |
| VENTOLIN HFA (ALBUTEROL SULFATE) 90ug/1 – 1 INHALER (200 puff) | Ventolin HFA 90 mcg | $54.90 | $59.90 | $57.00 |
| VERAPAMIL HYDROCHLORIDE 240mg/1 | ISOPTIN ER 240 MG | $3.40 | $8.40 | $16.00 |
| Vigamox (Moxifloxacin HCL OPTH ) 0.05% | Vigamox | $21.50 | $26.50 | $132.00 |
We can certainly send any orders for any of the above medicines and/or many other medicines to any pharmacies as desired. We do not prescribe chronic, long term opioids or narcotics, though we often refer patients to pain specialists.