Appropriate Prescribing of Opiates
Register | Three online modules focusing on educating the health care provider in how to safely and appropriately prescribe opioids. Author(s): Johnathan Goree, MD, UAMS. This activity is designed for newly licensed prescribers to obtain two of the three hours required within the first two years of obtaining an AR 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. Credits: AMA PRA Category 1 Credits ™ (2.00 hours), Non-Physician Attendance (2.00 hours).
AR-IMPACT: Free Weekly CME Pain Consultation Service for Physicians
AR-IMPACT was created to improve multi-disciplinary pain care and treatment for Arkansas physicians. It is a weekly interactive tele-video program offering free CME credit to better manage chronic pain patients and those who need their opioid dosage reduced.
The conference is held each Wednesday, from 12:00 to 1:00 and will begin with a brief didactic presentation about an aspect of the care, followed by a case conference format where doctors can present their difficult cases for discussion with their peers and with our panel of subspecialists. To learn more about AR-IMPACT, please visit https://learnondemand.org/lms/arimpact
Please join us live at noon on Wednesdays by going to https://join.uams.edu/invited.sf?secret=YtVKQkHsoWTgJaguonymZw&id=415081971 or calling 1-844-885-1319, access code: 415081971#.
For a list of conference days and topics please click this weblink https://arimpact.uams.edu/weekly-case-conferences/
AR-IMPACT is presented by UAMS through the generosity of Arkansas Blue Cross and Blue Shield and the Office of the State Drug Director, and in partnership with the Arkansas Medical Society, the Arkansas Academy of Family Medicine, the Arkansas Department of Health, and the Arkansas State Medical Board.
- Arkansas Emergency Department Opiod 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 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.
As of July 31, 2017, SB 339/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.
Physicians and pharmacists, to create an account, visit: http://www.arkansaspmp.com/practitioner-/-pharmacist/ and type
For any technical issues, please contact the help desk at 1-855-729-8917. Other questions may be directed to Denise Robertson, PD at firstname.lastname@example.org or call 501-683-3960. Arkansas’s Electronic Prescription Monitoring Program (PMP) was authorized in 2011 by Arkansas State Legislature Act 304. This program was created for the following purposes
- To enhance patient care by providing prescription monitoring information that will ensure legitimate use of controlled substances in health care
- To help curtail the misuse and abuse of controlled substances
- To assist in combating illegal trade in and diversion of controlled substances
- To enable access to prescription information by practitioners, law enforcement agents and other authorized individuals and agencies
Arkansas Emergency Department Opiod 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.
View the full text, including an explanation of each guideline, HERE.
- One medical provider should provide all opioids to treat a patient’s chronic pain.
- The administration of intravenous and intramuscular opioids in the ED for the relief of acute exacerbations of chronic pain is discouraged.
- Emergency medical providers should not provide replacement prescriptions for controlled substances that were lost, destroyed or stolen.
- Emergency medical providers should not provide replacement doses of methadone for patients in a methadone treatment program.
- Long-acting or controlled-release opioids (such as OxyContin®, fentanyl patches, and methadone) should not be prescribed from the ED.
- EDs are encouraged to use the Arkansas Prescription Drug Monitoring Program on appropriate patients.
- Physicians should send patient pain agreements to local EDs and work to include a plan for pain treatment in the ED.
- Prescriptions for controlled substances from the ED should state the patient is required to provide a government is-sued picture identification (ID) to the phar-macy filling the prescription.
- EDs are encouraged to photograph patients who present for pain related complaints without a government issued photo ID.
- EDs should coordinate the care of patients who frequently visit the ED using an ED care coordination program.
- EDs should maintain a list of clinics that provide primary care for patients of all payer types.
- EDs should perform screening, brief interventions and treatment referrals for patients with suspected prescription opiate abuse problems.
- The administration of Deme-rol® (Meperidine) in the ED is discouraged.
- 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.
- Prescriptions for opioid pain medication from the ED for acute injuries, such as fractured bones, in most cases should not exceed 30 pills.
- ED patients should be screened for substance abuse prior to prescribing opioid medication for acute pain.
- 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.