Spring 2018

9 nmdental.org By Peter Ryba, PharmD— Director, Prescription Monitoring Program The United States is in the midst of an epidemic of prescription opioid overdose deaths, which killed more than 63,600 people in 2016 alone. [1] Since 1999, the sales of prescription opioids in the United States nearly quadrupled, but the amount of pain Americans reported remained unchanged. [2] In fact, there were 249 million prescriptions written for opioids in 2013, meaning that every American could have had a bottle of pills. [2] Nevertheless, chronic pain is common and may require opioids for management. Compared to the 26 million patients with diabetes, 23 million patients with heart disease, and 12 million patients with cancer, there are nearly 100 million patients with chronic pain [3] . Chronic pain that is treated with opioids requires monitored treatment and care. In 2016, the state of New Mexico had the 12th highest rate of drug overdose deaths in the United States. This is an improvement compared to prior years—New Mexico was ranked second highest in 2014. Although there are many different undertakings that have contributed to the state’s progress, New Mexico has statistically higher drug overdose death rates compared to the United States average [1] and our work is far from being done. One tool available to dentists is the NMPrescriptionMonitoring Program (PMP). This is a web-based electronic database that aids in the collection of data specific to dispensed controlled substance prescriptions. PMP reports provide practitioners, pharmacists, and other authorized users the ability to review a patient’s controlled substance prescription history and assist in the prevention of diversion, abuse, misuse, and drug overdose deaths associated with controlled substance prescriptions. The New Mexico Board of Pharmacy (NM BOP) maintains our state’s PMP, which is hosted by Appriss Health. The NM BOP collects information on all controlled substance prescriptions dispensed by a pharmacy located in NM or shipped into NM. This information, which includes the drug name, dosage, quantity, day supply, dates written and filled, prescription number, practitioner name, pharmacy name, and payment method, is readily available to authorized users of the PMP site via a user friendly report. This tool is available to authorized users through the New Mexico PMP AWARxE website, https://newmexico.pmpaware.net . The PMP provides information which can raise “red flags” or risk factors, such as:  • patients who get multiple controlled substances from multiple providers (doctor and pharmacy shoppers);  • those who get prescriptions from nonlocal providers and/ or pharmacies;  • those who take higher doses of opioids than prescribed;  • those who use opioids in combination with other sedating substances, such as benzodiazepines;  • those who are frequently requesting early refill requests; and/or  • those who are using different payment methods, or cash only patients. continues on next page  MANDATED PRESCR I PT I ON MON I TOR I NG PROGRAM USAGE BY DENT I STS