Measures make it easier for medical professionals, safer for patients
New Hampshire’s new Opioid Prescribing Rules take effect January 1, 2017, impacting the way healthcare professionals prescribe, manage, and approach opioid therapy. Catholic Medical Center is prepared and proud to have taken the lead in developing several tools to aid in compliance.
Drug overdoses have surpassed motor vehicle crashes, breast cancer, and diabetes as a cause of death in New Hampshire. About 80% of those who use illicit street drugs such as heroin began by misusing prescription opioids, whether they were prescribed to themselves or obtained from a friend or relative. The new rules are far reaching by design, to reduce our reliance on prescription opioids and begin to reverse this crippling public health epidemic.
By New Hampshire statute, the Boards of Medicine, Nursing, Dental Examiners, Optometry, Naturopathic Examiners, Veterinary Medicine, and Podiatry were all required to establish opioid prescribing rules. “Patients throughout New Hampshire can expect to encounter the guidelines when seeking relief from acute or chronic pain for themselves or someone in their care,” says Dr. William Goodman, CMC’s Chief Medical Officer and a recognized resource in the community fight against the opioid epidemic. Depending on the circumstances a prescriber may be required to:
-Complete a risk-assessment tool to determine whether the patient is appropriate for opioids
-Provide a written consent document informing the patient of the risks associated with opioids
-Use a written treatment agreement outlining the responsibilities of both the patient and the prescriber
Patients treated with opioids for acute pain must be prescribed the lowest effective dose, for a limited duration. Those treated for chronic pain for longer than 90 days may be required to undergo random, periodic urine drug testing to ensure they are benefiting from the pain medication. In emergency departments, urgent care, and walk-in clinics, where there is no continuity of care between patient and prescriber, prescribers will have the extra restriction that they cannot write an opioid prescription for longer than seven days. For those patients who need a longer course of therapy, they will be referred to an office where they can receive care with ongoing follow-up.
Every prescriber in the state will be required to use the New Hampshire Prescription Data Monitoring Program (PDMP), a database that tracks opioid prescribing patterns in New Hampshire and surrounding states, prior to giving a patient their initial opioid prescription. This database aims to reveal patients who take an excessive amount of these powerful pain medications and who is prescribing them. The PDMP was made available to New Hampshire prescribers over a year ago and CMC developed a shortcut for its providers to easily access it from within a patient’s medical record. The success of the PDMP is already evident in New Hampshire, as we have just started to see a noticeable decline in the number of opioid prescriptions written in the state.
“While more accountability in prescribing practices is well overdue, the new rules add several steps and considerations for providers prescribing an opioid. CMC has worked to make this as clear and simple as possible for its providers and patients,” says Dr. Goodman. These measures include: a patient education document that describes the most common risks and side-effects of an opioid, tools that make it easier for providers to document their compliance with the rules, an opioid prescribing form that contains links to the resources providers may need, and a pop-up compliance reminder that is triggered when a patient is discharged with an opioid prescription. These changes will help identify people suffering from addiction and community resources are being developed to meet their needs.
To help prescribers better understand these far-reaching new rules, and how to comply with them, CMC is joining with Elliot Hospital and Dartmouth-Hitchcock Medical Center to host an education session at the end of January at the Manchester Public Health Department.