6/11/2013 PDMP Training & Technical Assistance Center Status of Prescription Drug Monitoring Programs (PDMPs) * To view PDMP Contact information, hover the mouse pointer over the state abbreviation VT ME NH WA MA MT ND MN NY RI OR WI CT SD ID MI WY PA NJ IA NE OH DE IL IN NV WV UT VA MD CO KS DC KY CA MO NC Arkansas Department of Health TN OK SC AZ NM AR GA AL MS 4815 West Markham Street ● Little Rock, Arkansas AK TX 72205-3867 ● Telephone (501) 661-2000 LA FL Governor Mike Beebe Nathaniel Smith, MD, MPH, Interim Director and State Health Officer Operational PDMPs Enacted PDMP legislation, but HI program not yet operational Legislation Pending G U Research is current as of April 10, 2013 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 Arkansas Crime Laboratory (SAMHSA) In 2011, approximately 1250 autopsies were performed in Arkansas. Drug intoxication, either Released January 8, 2013: Prescription drug misuse is second only to marijuana as the nation’s most prevalent illicit drug from prescription or illicit drugs or a combination problem. thereof, was the primary cause of death in 1 of 9 cases. Arkansas ranked among the top five states for nonmedical use of prescription pain relievers by persons aged 12 and older Drugs, including prescription drugs, were a from 2010 – 2011. contributory cause of death in 1 of 4 cases. 1
6/11/2013 Arkansas Prevention Network A PMP is a program that keeps records of all dispenser transactions of controlled substances. 22% of Arkansas high school students say they have abused prescription drugs by the time they are seniors. Schedule II – V are reported. 1 in 3 teens reports knowing someone who abuses prescription drugs. Reports are generated to aide prescribers and dispensers in enhancing patient care. 1 in 5 teens share their prescription drugs with friends. Data can assist in curtailing misuse and abuse Over 60% of teens believe that most teens get their drugs from their parent’s medicine cabinet. of controlled prescription drugs. 2010 Arkansas Prevention Needs Assessment Survey, April 2011 Alliance of States with Prescription Drug Monitoring Programs The Arkansas Prescription Monitoring Program (AR PMP) was established by ACT 304 of 2011 in order to: Education and information Enhance patient care Public health initiatives Help curtail the misuse and abuse of controlled substances. Assist in combating illegal trade and diversion of controlled Early intervention and prevention substances. Enable access to prescription information by authorized Investigations and enforcement individuals. Protection of confidentiality Alliance of States with Prescription Monitoring Programs Act 304 directed the Arkansas Department of Notification Letters sent to 1,140 Pharmacies Health to seek funding and implement the AR January 15, 2013 PMP by March 1, 2013. AR PMP Final Rules and Regulations approved Health Information Designs was contracted to by the Board of Health January 24, 2013 construct the AR PMP database in the fall of 2012. AR PMP Website Operational February 14, 2013 for Dispenser Upload Accounts. AR PMP Rules and Regulations Public Hearing January 8, 2013 2
6/11/2013 Dispensers of Controlled Substances: AR PMP Operational March 1, 2013 for Weekly Reporting of Controlled Substances Dispensing In-state Pharmacies Data. Out-of-State Pharmacies Practitioners dispensing controlled AR PMP Operational in May 2013 for direct substances access by prescribers and pharmacists. AR PMP Operational in June 2013 for indirect access by law enforcement and regulatory boards. Alliance of States with Prescription Drug Monitoring Programs Controlled substance dispensing data reporting is web-based. Information is sent securely online Prescribers & Pharmacists - for their patients to the PMP central database. Licensing boards – pursuant to an investigation Law Enforcement – pursuant to a search Reporting to the PMP is required weekly for the previous Sunday – Saturday dispensing warrant period. Other State PMPs Schedule II – V : including Tramadol and Researchers and educators (de-identified Nalbuphine plus solid dosage forms of ephedrine, pseudoephedrine and information) phenylpropanolamine dispensed by prescription. Alliance of States with Prescription Drug Monitoring Programs Registration with the PMP Dispensers Receive Login Credentials Login to Secure Web Portal State Request Report Pharmacists Prescribers PMP View Report Online Print Report Law Enforcement & Regulatory Boards Typical for Prescribers/Pharmacists Alliance of States with Prescription Monitoring Programs *Alliance of States with Prescription Monitoring Programs 3
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6/11/2013 ▫ 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 6
6/11/2013 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 7
6/11/2013 Administrative Reports Threshold Reports De-identified Reports for research Specialized interest and needs reports Prescriber (>180mg/day) Oxycodone IR 30mg tablet 8
6/11/2013 Prescription history of a current or a new 24/7 access via web portal patient Can be accessed before filling controlled Check for appearance of addiction or substance prescriptions undertreated pain Data is updated weekly Check for appearance of misuse, multiple Covers all sources of payment prescribers, multiple pharmacies Covers all controlled substances Check for drug interactions or other harm Check for compliance with pain contracts Alliance of States with Prescriptions Alliance of States with Prescriptions Drug Monitoring Drug Monitoring Programs Programs 9
6/11/2013 Unsolicited or Threshold Reporting is To Fill or Not to Fill….THAT is the question! proactive Opportunity to counsel patient on proper use Alert prescribers to access the PMP The PMP analyzes collected data Alert other pharmacies to access the PMP 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 Pharmacy/Clinic signage advising Narcotics Anonymous: www.na.org patients of your participation in the AR PMP. Alcoholics Anonymous: www.aa.org Frequently Asked Questions Al-Anon/Alateen: www.al-anon.alateen.org Reports Section Substance Abuse Treatment Facility Locator: http://dasis3.samhsa.gov Interstate Data Sharing As of May 20, 2013, • 4,272,925 controlled substance prescription records Automated Unsolicited Reporting were in the database. • 842,875 were for narcotic analgesics Education Programs for: • Since January 1, 2013 -- 478,948 prescriptions for Hydrocodone/Apap have been dispensed (28,114,520 Prescribers tabs) • Since January 1, 2013 – 114,533 prescriptions for Pharmacists Oxycodone have been dispensed (includes liquids, tabs and caps) Law Enforcement • Since January 1, 2013 – 7,136 prescriptions for Hydromorphone have been dispensed. (609,173 tabs) Alliance of States with Prescription Drug Monitoring Programs 10
6/11/2013 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 11
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