RESOURCES

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Prescribing & Prescription Drug Education

DEA Required Training

Beginning on June 27, 2023, DEA-registered physicians are now required to check a box on their online DEA registration form affirming that they have completed the new training requirement. Many states already require physicians and other medical professionals to complete CME hours on safer prescribing of opioids, but this new requirement asks physicians to have additional education on the treatment and management of patients with opioid or other substance use disorders. Read the DEA training notice here.

The deadline to meet this new requirement is the date of a practitioner’s next scheduled DEA registration submission, but you do not have to complete the training in one session. The listed CME activities can be taken in any combination to fulfill the eight-hour requirement that applies to DEA-registered physicians. They cover areas such as:

• Safe opioid prescribing and management.
• Addiction treatment.
• Managing addiction in special populations.
• Preventing and managing opioid overdoses.

AR-IMPACT: Free Pain Management Televideo Conferences

UAMS AR-IMPACT Speaker’s Bureau is a FREE interactive televideo lecture series designed to help Arkansas clinicians better manage their chronic pain patients and those who need their opioid dosage reduced.  Each of the AR IMPACT team members will travel to the UAMS Regional Centers to provide lectures on various topics related to pain management and opioid use disorder.

You can access these lectures remotely from your computer or handheld device.  Continuing medical education credit for physicians, pharmacists, nurses, physician assistants, and social workers is available with two hours of credit being offered per lecture date.

Visit uamshealth.org/ar-impact for more information.

AR-IMPACT was launched through a partnership between UAMS, the Arkansas Medical Society, the Arkansas Academy of Family Medicine, the Arkansas Department of Health, and the Arkansas State Medical Board. It is also possible through the generosity of Arkansas Blue Cross and Blue Shield and the Office of the State Drug Director.

Opioid Stewardship

Three online modules focusing on educating the health care provider in how to safely and appropriately prescribe opioids. This activity is designed for newly licensed prescribers to obtain two of the three hours required within the first two years of obtaining an Arkansas license on the topic of Appropriate Prescribing. These modules also will be of benefit to other health care providers with an interest in, or who prescribe opioids. 

Register here.

Credits: AMA PRA Category 1 Credits ™ (2.00 hours), Non-Physician Attendance (2.00 hours).

Substance Use Disorder Resources

• Arkansas Emergency Department Opioid Prescribing (scroll down)
• Mandatory Usage of Prescription Drug Monitoring Program (SB 339/Act 820) (passed 2017): Requires checking the PDMP each time a prescription for Schedule II or III opioid is written and the first time for a benzodiazepine.
• Arkansas Prescription Drug Abuse Act (passed 2015) This AMS-supported law allows the Department of Health to develop algorithms to determine if a patient is being prescribed opioids within a 30-day period by more than three physicians; allow prescriber to delegate access to the database; require opioid prescribing guidelines for emergency departments; and provides immunity for good faith reporting of suspected drug diversion.
• United States Drug Enforcement Administration (DEA)
• For Patients: Common misunderstandings/miscommunication regarding the law
  • The Arkansas legislature has not passed any laws that prohibit your primary care doctor from prescribing pain medication.
  • The Arkansas legislature has not passed any laws requiring you to be treated in a pain clinic.
  • If your physician has told you these things, please suggest they contact our office (501-224-8967) to receive accurate information on prescribing requirements in Arkansas.

Arkansas Prescription Monitoring Program

In July 2017, Act 820 requires checking the PDMP each time a prescription for Schedule II or III opioid is written and the first time for a benzodiazepine.

The purpose of the AR PDMP is to:

1. Enhance patient care by providing prescription monitoring information that will ensure legitimate use of controlled substances in health care, including palliative care, research, and other medical pharmacological uses;
2. Help to curtail the misuse and abuse of controlled substances;
3. Assist in combating illegal trade in and diversion of controlled substances; and
4. Enable access to prescription information by practitioners, law enforcement agents, and other authorized individuals and agencies.

Who has access to the Arkansas Prescription Drug Monitoring Program?

Per law, the Arkansas Department of Health grants assessments of the AR PDMP database to authorized users such as prescribers (physicians, nurse practitioners, dentists, etc.), pharmacists, delegates of prescribers/pharmacists, professional licensing boards, and certified law enforcement prescription drug diversion investigators.

CLICK HERE FOR PDMP RESOURCES FOR HEALTHCARE PROVIDERS.

For any technical issues, please contact PDMP Support at 501-683-3960. Other questions can be directed to
Jamie Turpin, PharmD, Prescription Drug Monitoring Program Administrator at the Arkansas Department of Health.
Email: Jamie.turpin@arkansas.gov
Phone: 501-661-2162

Arkansas Emergency Department Opioid Prescribing Guidelines

Print One Page Flyer: Click Here

The emergency department (ED) is the largest ambulatory source for opioid analgesics with 39% of all opioids prescribed, administered, or continued coming from emergency departments.1 According to the Drug Abuse Warning Network (DAWN), the estimated number of ED visits for nonmedical use of opioid analgesics more than doubled from 2004 to 2008 (from 144,600 to 305,900 visits).2 As the use of prescription opioids for chronic non-cancer pain has increased, so have unintended consequences related to opioids.

These guidelines are intended to help EDs reduce the inappropriate use of opioid analgesics while pre-serving the vital role of the ED to treat patients with emergent medical conditions. These guidelines were developed by the Emergency Department Opioid Abuse Work Group sponsored by the Arkansas Chapter of American College of Emergency Physicians and the Arkansas Medical Society. They are supported by the following organizations: State of Arkansas State Drug Director, The Arkansas Depart-ment of Health, The Arkansas Foundation for Medical Care, The University of Arkansas for Medical Sciences, and The Arkansas Hospital Association.

Disclaimer: This document should not be used to establish any standard of care. No legal proceeding, including medical malpractice proceedings or disciplinary hearings, should reference a deviation from any part of this document as constituting a breach of professional conduct. These guidelines are only an educational tool. Clinicians should use their own clinical judgment and not base clinical decisions solely on this document. The following recommendations are not founded in evidence-based research but are based on promising interventions and expert opinion. Additional research is needed to under-stand the impact of these interventions on decreasing unintentional drug poisoning and on health care costs. All of the following recommendations should be implemented in concert and collaboration with public health entities and other relevant stakeholders.

Guidelines

View the full text, including an explanation of each guideline, HERE.

1. One medical provider should provide all opioids to treat a patient’s chronic pain.
2. The administration of intravenous and intramuscular opioids in the ED for the relief of acute exacerbations of chronic pain is discouraged.
3. Emergency medical providers should not provide replacement prescriptions for controlled substances that were lost, destroyed or stolen.
4. Emergency medical providers should not provide replacement doses of methadone for patients in a methadone treatment program.
5. Long-acting or controlled-release opioids (such as OxyContin®, fentanyl patches, and methadone) should not be prescribed from the ED.
6. EDs are encouraged to use the Arkansas Prescription Drug Monitoring Program on appropriate patients.
7. Physicians should send patient pain agreements to local EDs and work to include a plan for pain treatment in the ED.
8. Prescriptions for controlled substances from the ED should state the patient is required to provide a government is-sued picture identification (ID) to the pharmacy filling the prescription.
9. EDs are encouraged to photograph patients who present for pain related complaints without a government issued photo ID.
10. EDs should coordinate the care of patients who frequently visit the ED using an ED care coordination program.
11. EDs should maintain a list of clinics that provide primary care for patients of all payer types.
12. EDs should perform screening, brief interventions and treatment referrals for patients with suspected prescription opiate abuse problems.
13. The administration of Demerol® (Meperidine) in the ED is discouraged.
14. For exacerbations of chronic pain, the emergency medical provider should contact the patient’s primary opioid prescriber or pharmacy. The emergency medical provider should only prescribe enough pills to last until the office of the patient’s primary opioid prescriber opens.
15. Prescriptions for opioid pain medication from the ED for acute injuries, such as fractured bones, in most cases should not exceed 30 pills.
16. ED patients should be screened for substance abuse prior to prescribing opioid medication for acute pain.
17. The emergency physician is required by law to evaluate an ED patient who reports pain. The law allows the emergency physician to use their clinical judgment when treating pain and does not require the use of opioids.