state of the states prescription drug abuse and overdose policy national center for injury...
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State of the States Prescription Drug Abuse and
Overdose Policy
National Center for Injury Prevention and Control
Division of Unintentional Injury Prevention
Christopher M. Jones, PharmD, MPHLCDR, US Public Health Service
Division of Unintentional Injury PreventionNational Center for Injury Prevention and Control
Centers for Disease Control and Prevention
Overview
Current Policy Strategies State laws/regulations PDMPs Prescribing Guidelines
Policy Strategy Trends
Doctor Shopping Laws
CDC PHLP 2013
Tamper Resistant Forms
CDC PHLP 2013
Physical Exam Requirements
CDC PHLP 2013
Patient ID Requirements
CDC PHLP 2013
Pill Mill Laws
CDC PHLP 2013
Prescription Limits
CDC PHLP 2013
Immunity from Prosecution
CDC PHLP 2013
Prescribing Guidelines
Prescribing guidelines Washington – Rule Utah New Mexico Oklahoma NYC
ED prescribing guidelines Washington Ohio Oklahoma Arkansas Oregon Maine NYC
PDMPs and Health Information Technology
Interoperability Active – Alabama, Arizona, Connecticut, Florida, Illinois,
Indiana, Kansas, Kentucky, Louisiana, Maine, Michigan, New Mexico, North Dakota, Ohio, South Carolina, South Dakota, Virginia
In Process – California, Colorado, Delaware, Idaho, Massachusetts, Minnesota, Mississippi, Montana, Nevada, New Jersey, North Carolina, Rhode Island, Texas, Utah, Washington, West Virginia
EHR Integration Florida, Illinois, Indiana, Kansas, Maine, Ohio, Texas,
Washington, West Virginia
PDMP CoE at Brandeis University, NABP PMPi, MITRE Corp, SAMHSA
PDMP Proactive Reporting
PDMP CoE Brandeis University. 2013.
Top 10 Proposed Legislation
1. Immunity from prosecution laws and/or naloxone – 21 states
2. Required use/registration of PDMP – 13 states3. PDMP enhancements (access, reporting time,
delegates) – 11 states4. Creation of Commission or Working Group – 9 states5. Mandatory provider education on pain/addiction – 7
states6. Abuse-deterrent formulation substitution
restrictions – 6 states7. Opioid prescribing standards/rules – 5 states8. PDMP funding – 4 states9. OTP standards – 4 states10. Quantity/dose limits – 2 states
CQ State Tracker, CDC PHLP. 2013
Honorable Mentions
1. Alaska – required consultation with pain management specialist prior to prescribing ≥ 120 MME of an opioid
2. Iowa – promulgate rules/regulations on opioid prescribing in the ED
3. New Mexico – rescheduling hydrocodone4. West Virginia - Prohibit prescribing of
OxyContin or fentanyl unless the product also contains naloxone
CQ State Tracker, CDC PHLP. 2013
Conclusions
State level policies can significantly impact the prescription drug overdose epidemic
Many states are instituting similar policies…no need to recreate the wheel
Robust evaluations of policies and dissemination of findings are critical
Christopher M. Jones, PharmD, MPH
Thank You
The findings and conclusions in this report are those of the author and do not necessarily represent the views of the Centers for Disease Control and Prevention.