New Jersey State Monitor

Q1 - 2015

State Overview Relating to Prescribing of Controlled Substances to Treat Pain and Clinical Drug Testing

Does New Jersey have a Prescription Drug Monitoring Program?

Yes. New Jersey has a Prescription Drug Monitoring Pro-gram. The program is a statewide database that collects prescription data on Controlled Dangerous Substances (CDS) and Human Growth Hormone (HGH) dispensed in outpatient settings in New Jersey, and by out-of-state pharmacies dispensing into New Jersey. Access to the NJPMP is granted to prescribers and pharmacists who are licensed by the State of New Jersey and in good standing with their respective licensing boards. Patient information in the NJPMP is intended to help prescribers and pharma-cists provide better-informed patient care. The information will help supplement patient evaluations, confirm patients’ drug histories, and document compliance with therapeu-tic regimens. When prescribers or pharmacists identify a patient as potentially having an issue of concern regarding drug use, they are encouraged to help the patient locate assistance and take any other action the prescriber or pharmacist deems appropriate. The NJPMP also serves as an effective tool for identifying those who fraudulently obtain prescription drugs or are otherwise involved in the criminal diversion of prescription medication.

Does New Jersey have a Pain Clinic Registration Act? Are there specific standards for pain clinics on drug testing? Are there general pain management standards that make suggestions about drug testing?

At this time, New Jersey does not have a Pain Clinic Registration Act and the state lacks any specific rules or standards on UDT in pain management. The existing New Jersey Board of Medical Examiners’ pain management regulation does not contain specific standards for UDT.

Does New Jersey have guidance on the Treatment of Opioid Addiction in the Medical Office? Do these materials make reference to drug testing as part of the patient treatment plan?

At this time, New Jersey does not have specific clinical guidance on the Treatment of Opioid Addiction in the Medi-cal Office. New Jersey practitioners may wish to review the FSMB’s Model Policy on this same topic.

Quick Links and Resources

New Jersey Materials

New Jersey Board of Medical Examiners http://www.state.nj.us/lps/ca/bme/index.html

New Jersey Regulations for Medical Practice (Several Sections Pertain to Controlled Substance Prescribing, including the use in pain management) http://www.njconsumeraffairs.gov/chapters/Chapter %2035%20Board%20of%20Medical%20Examiners.pdf

New Jersey Prescription Drug Monitoring Program http://www.njconsumeraffairs.gov/pmp/

New Jersey “Be Aware” Rx Education Program (associated with the PMP) http://www.njconsumeraffairs.gov/pmp/aware.htm

New Jersey Information on Medical Marihuana Program http://nj.gov/health/medicalmarijuana/presentation/ presentation/mmp/mmp.html

Federation of State Medical Boardshttp://www.fsmb.org/index.html

Federation of State Medical Boards Model Policy on the Use of Opioid Analgesics for the Treatment of Chronic Painhttp://www.fsmb.org/pdf/pain_policy_july2013.pdf

Federation of State Medical Boards Model Policy on DATA 2000 and Treatment of Opioid Addiction in the Medical Officehttp://www.fsmb.org/pdf/2013_model_policy_treatment_ opioid_addiction.pdf

On the Horizon

New Jersey has several new and pending pieces of legis-

lation impacting the pain management practitioner. For

example, SB2366 proposes that healthcare practitioners

be required to tell patients about the addiction potential of

controlled dangerous substances prior to issuing prescrip-

tion. SB2366 appears to be an effort to spell out informed

consent requirements when therapy involves controlled

dangerous substances. Another topic area of new and pend-

ing legislation is opioid overdose prevention. New Jersey

practitioners will want to track amendments to the state’s

Overdose Prevention Act, including efforts to obtain cover-

age for buprenorphine and naloxone, i.e., Assembly No. 3830.

In 2015, New Jersey is likely to experience several updates

to existing regulations, many of which will be focused upon

opioid overdose prevention through the proactive assess-

ment and monitoring of patients deemed “at-risk” for an

overdose event and including the prescribing of naloxone as

one means to prevent overdose.

Important Notice To Readers

Quest Diagnostics does not intend for this document to impart any legal advice. The document is intended to be educational and readers are encouraged to review this information with qualified legal counsel before taking any action relative to controlled substance prescribing and clinical drug testing.

QuestDiagnostics.comQuest, Quest Diagnostics, any associated logos, and all associated Quest Diagnostics registered or unregistered trademarks are the property of Quest Diagnostics.

©2015 Quest Diagnostics Incorporated. All rights reserved. NJSM001 03/2015

Q1 - 2015

Role of Clinical Drug Testing in the Management of Patients on Chronic Opioid Therapy

Brief Summary

New Jersey is an active state for new legislation relating to opioid overdose prevention and updates to the state’s existing prescription drug monitoring program. However, while the New Jersey Board of Medical Examiners has an existing board regulation on limitations associated with prescribing controlled substances and exceptions for pain management (“§13:35-7.6”), the regulation is gen-eral and lacking details about urine drug testing (UDT) and its role in pain management. Instead, the existing regulation contains the following language that arguably contemplates a role for some form of drug testing as a means of monitoring the patient:

A practitioner shall remain alert to the possibil-ity that controlled substances may be misused or diverted. A practitioner managing pain in a patient with a history of substance abuse shall exercise extra care by way of monitoring, documentation and pos-sible consultation with addiction medicine special-ists, and should consider the use of an agreement between the practitioner and the patient concerning controlled substance use and consequences for misuse.

New Jersey practitioners may wish to review the Federa-tion of State Medical Boards’ 2013 Model Guidelines on the Use of Chronic Opioid Therapy for the Treatment of Chronic, Non-Cancer Pain, and consider whether the guidance in that document will help them meet the requirements of §13:35-7.6.