State Eyes New Rx Monitoring; Adds Dentists, ER Physicians for Look ups

TRENTON – Advancing New Jersey’s fight against opioid addiction, Attorney General Gurbir S. Grewal and the Office of the New Jersey Coordinator for Addiction Responses and Enforcement Strategies (“NJ CARES”) Nov. 15  announced that the Division of Consumer Affairs has proposed new rules for the NJ Prescription Monitoring Program (“NJPMP”).
They would further mandate use of the centralized database and make it easier for prescribers to fulfill their duty to monitor patient use of opioid painkillers and other controlled drugs that can lead to addiction and fatal overdoses.
According to a release, the proposed rules broaden conditions under which practitioners are required to look up patient records on the NJPMP prior to prescribing opioid pain medication, adding new requirements for prescriptions written in hospital emergency rooms, after procedures such as wisdom teeth removal, and in other situations. They also expand the types of drugs that trigger look-up requirements. Prescribers would now be required to check the NJPMP before prescribing any opioid, not solely those in the most tightly restricted “Schedule II” category.
And for the first time, physicians would have to check the NJPMP before prescribing benzodiazepines, a class of sedative drugs like Xanax, Ativan, and Klonopin that, when taken in combination with opioids, greatly increase the chance of a fatal overdose.
“New Jersey’s Prescription Monitoring Program is one of our most powerful tools in combatting addiction to prescription drugs,” stated Grewal. “With these new rules, the NJPMP will be even more effective in preventing abuse and diversion of opioids and other drugs fueling New Jersey’s addiction crisis.”
The NJPMP is a centralized data sharing system that tracks prescription sales of opioids and other controlled dangerous substances (“CDS”). The information contained in the database can help prescribers and pharmacists provide better care and identify signs that individuals are abusing or diverting prescription medications.
Fifteen states Connecticut, Delaware, Maine, Massachusetts, Minnesota, New Hampshire, New York, North Carolina, Ohio, Pennsylvania, Rhode Island, South Carolina, Vermont, Virginia, and West Virginia share data with the NJPMP.
In addition to expanding the conditions under which a prescriber is required to look up patient records on the NJPMP, the new rules expand access to that information.
Direct access to the NJPMP is limited to prescribers and pharmacists who are licensed by the State of New Jersey. Prescribers may delegate their access authority to other healthcare professionals who can make the checks for them. The proposed rules expand delegate access to include athletic trainers in a clinical setting and medical scribes employed by a hospital’s emergency department. The proposed rules also would allow electronic health systems to access the NJPMP database so information could be directly integrated into electronic medical records, making it easier for practitioners to view it.
“The members of New Jersey’s health care community are important allies in the battle to end the opioid addiction epidemic,” stated Sharon M. Joyce, Director of NJ CARES. “By expanding access to the NJPMP and making it easier for practitioners to use the database in their daily practice, we are empowering them as partners in our fight to end this national health crisis.”
The proposed amendments to the NJPMP rules would eliminate language that provided lookup exemptions for opioids prescribed for acute or chronic pain in the emergency department of a general hospital as long as the quantity prescribed did not exceed a five-day supply. Under the new rules, emergency room practitioners would be required to check the NJPMP for all opioids and benzodiazepines regardless of the duration of the prescription.
In addition, the Division proposes to amend language that currently provides look-up exemptions for practitioners prescribing less than a 30-day supply of opioids to patients immediately after an “operation, procedure, or treatment for acute trauma.” Exemptions would now apply only to practitioners prescribing no more than a five-day supply to patients who have undergone an operation or treatment for acute trauma in a general hospital or a licensed ambulatory care facility. There would no longer be lookup exemptions for opioid pain medication prescribed after medical “procedures” such as wisdom teeth removal.
The Division has also proposed changes to the rules pertaining to pharmacists’ use of the NJPMP as well. Currently, a pharmacy is required to report information pertaining to every prescription filled for CDS or certain other drugs.
The new rules also would require pharmacies to report identifying information for any individual, other than the patient for whom the prescription was written, who picks up a CDS prescription, if the pharmacist has a reasonable belief that the person may be seeking the drug for any reason other than delivering it to the patient for the treatment of an existing medical condition.
“We’re eliminating exemptions and adding new requirements that will enhance protections against prescription drug addiction, diversion, and overdose,” stated Paul R. Rodríguez, Acting Director of the Division of Consumer Affairs. “Patients can become addicted to opioids in a matter of days, and when taken with sedatives the combination can be fatal. We want to makes sure these powerful drugs are not falling into the hands of those who will abuse them or sell them on the street and that prescribers are aware of the other medications that their patients may be taking.”
The proposed rules and amendments were recently published in the NJ Register and will be subject to administrative review and public comment before they can take effect.
The proposed rules and amendments, and information on how to submit a comment by Dec.14, 2018, can be viewed on the Division’s website.