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Arkansas Department of Health

4815 West Markham Street ● Little Rock, Arkansas 72205-3867 ● Telephone (501) 661-2000

Governor Mike Beebe Nathaniel Smith, MD, MPH, Interim Director and State

Health Officer

Status of Prescription Drug Monitoring Programs (PDMPs)

Research is current as of April 10, 2013

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WY MI

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Operational PDMPs Enacted PDMP legislation, but program not yet operational Legislation Pending G

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RI CT

NJ

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MD DC

PDMP Training & Technical Assistance Center

* To view PDMP Contact information, hover the mouse pointer over the state abbreviation

National Vital Statistics System (CDC)

Released January 14, 2007: Drug-induced deaths had become more common than alcohol-induced or firearm-related deaths in the U.S.

Released November 4, 2011: Drug overdose deaths surpassed traffic accident deaths in the U.S.

Arkansas ranked among the second highest group of states nationally in overall drug overdose deaths in 2008, 38% of which were due to nonmedical use of opioid pain relievers.

In 2010, Arkansas was among the highest group nationally in the rate of kilograms of opioid pain relievers sold per 10,000 people.

CDC, Morbidity and Mortality Weekly Report, 60(43): 1490,2011 CDC, Morbidity and Mortality Weekly Report, 60(43): 1490,2011

National Survey on Drug Use and Health (SAMHSA)

Released January 8, 2013: Prescription drug misuse is second only to marijuana as the nation’s most prevalent illicit drug problem.

Arkansas ranked among the top five states for nonmedical use of prescription pain relievers by persons aged 12 and older from 2010 – 2011.

Arkansas Crime Laboratory

In 2011, approximately 1250 autopsies were performed in Arkansas. Drug intoxication, either from prescription or illicit drugs or a combination thereof, was the primary cause of death in 1 of 9 cases.

Drugs, including prescription drugs, were a contributory cause of death in 1 of 4 cases.

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Arkansas Prevention Network

22% of Arkansas high school students say they have abused prescription drugs by the time they are seniors.

1 in 3 teens reports knowing someone who abuses prescription drugs.

1 in 5 teens share their prescription drugs with friends.

Over 60% of teens believe that most teens get their drugs from their parent’s medicine cabinet.

2010 Arkansas Prevention Needs Assessment Survey, April 2011

A PMP is a program that keeps records of all dispenser transactions of controlled substances.

Schedule II – V are reported.

Reports are generated to aide prescribers and dispensers in enhancing patient care.

Data can assist in curtailing misuse and abuse of controlled prescription drugs.

Alliance of States with Prescription Drug Monitoring Programs

Education and information

Public health initiatives

Early intervention and prevention

Investigations and enforcement

Protection of confidentiality

Alliance of States with Prescription Monitoring Programs

The Arkansas Prescription Monitoring Program (AR PMP) was established by ACT 304 of 2011 in order to: Enhance patient care

Help curtail the misuse and abuse of controlled substances.

Assist in combating illegal trade and diversion of controlled substances.

Enable access to prescription information by authorized individuals.

Act 304 directed the Arkansas Department of Health to seek funding and implement the AR PMP by March 1, 2013.

Health Information Designs was contracted to construct the AR PMP database in the fall of 2012.

AR PMP Rules and Regulations Public Hearing January 8, 2013

Notification Letters sent to 1,140 Pharmacies January 15, 2013

AR PMP Final Rules and Regulations approved by the Board of Health January 24, 2013

AR PMP Website Operational February 14, 2013 for Dispenser Upload Accounts.

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AR PMP Operational March 1, 2013 for Weekly Reporting of Controlled Substances Dispensing Data.

AR PMP Operational in May 2013 for direct access by prescribers and pharmacists.

AR PMP Operational in June 2013 for indirect access by law enforcement and regulatory boards.

Dispensers of Controlled Substances:

In-state Pharmacies

Out-of-State Pharmacies

Practitioners dispensing controlled substances

Alliance of States with Prescription Drug Monitoring Programs

Controlled substance dispensing data reporting is web-based. Information is sent securely online to the PMP central database.

Reporting to the PMP is required weekly for the previous Sunday – Saturday dispensing period.

Schedule II – V : including Tramadol and Nalbuphine plus solid dosage forms of ephedrine, pseudoephedrine and phenylpropanolamine dispensed by prescription.

Prescribers & Pharmacists - for their patients

Licensing boards – pursuant to an investigation

Law Enforcement – pursuant to a search warrant

Other State PMPs

Researchers and educators (de-identified information)

Alliance of States with Prescription

Drug Monitoring Programs

State PMP

Dispensers

Prescribers

Law Enforcement & Regulatory

Boards

Pharmacists

*Alliance of States with Prescription Monitoring Programs

Registration with the PMP

Receive Login Credentials

Login to Secure Web Portal

Request Report

View Report Online

Print Report Typical for Prescribers/Pharmacists

Alliance of States with Prescription Monitoring Programs

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▫ Patient history

Check previous use of controlled substances

Check for misuse via multiple prescribers or pharmacies

Check for medication duplication

Check for drug interactions

Check for compliance with pain contracts

Alliance of States with Prescription Drug Monitoring Programs

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Prescriber History A physician can confirm the authenticity of

prescriptions attributed to his/her DEA number

Check his/her own prescribing history

Run monthly prescriber history reports

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Administrative Reports

Threshold Reports

De-identified Reports for research

Specialized interest and needs reports

Prescriber (>180mg/day) Oxycodone IR 30mg tablet

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Prescription history of a current or a new patient

Check for appearance of addiction or undertreated pain

Check for appearance of misuse, multiple prescribers, multiple pharmacies

Check for drug interactions or other harm

Check for compliance with pain contracts

Alliance of States with Prescriptions Drug Monitoring Programs

24/7 access via web portal

Can be accessed before filling controlled substance prescriptions

Data is updated weekly

Covers all sources of payment

Covers all controlled substances

Alliance of States with Prescriptions Drug Monitoring Programs

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Unsolicited or Threshold Reporting is proactive

The PMP analyzes collected data according to selected parameters

Reports/Alerts can be sent to pharmacists and prescribers

Automated in the future

Alliance of States with Prescriptions Drug Monitoring Programs

To Fill or Not to Fill….THAT is the question!

Opportunity to counsel patient on proper use

Alert prescribers to access the PMP

Alert other pharmacies to access the PMP

Pharmacy/Clinic signage advising patients of your participation in the AR PMP.

Frequently Asked Questions

Reports Section

Narcotics Anonymous: www.na.org

Alcoholics Anonymous: www.aa.org

Al-Anon/Alateen: www.al-anon.alateen.org

Substance Abuse Treatment Facility Locator: http://dasis3.samhsa.gov

Interstate Data Sharing

Automated Unsolicited Reporting

Education Programs for:

Prescribers

Pharmacists

Law Enforcement

Alliance of States with Prescription

Drug Monitoring Programs

As of May 20, 2013, • 4,272,925 controlled substance prescription records

were in the database.

• 842,875 were for narcotic analgesics

• Since January 1, 2013 -- 478,948 prescriptions for Hydrocodone/Apap have been dispensed (28,114,520 tabs)

• Since January 1, 2013 – 114,533 prescriptions for Oxycodone have been dispensed (includes liquids, tabs and caps)

• Since January 1, 2013 – 7,136 prescriptions for Hydromorphone have been dispensed. (609,173 tabs)

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Denise Robertson, P.D. PMP Administrator

4815 West Markham Street Slot 25 Little Rock, Arkansas 72205-3867

501-683-3960 501-661-2769

denise.robertson@arkansas.gov