State of the States Prescription Drug Abuse and

Overdose Policy

National Center for Injury Prevention and Control

Division of Unintentional Injury Prevention

Christopher M. Jones, PharmD, MPHLCDR, US Public Health Service

Division of Unintentional Injury PreventionNational Center for Injury Prevention and Control

Centers for Disease Control and Prevention

Overview

Current Policy Strategies State laws/regulations PDMPs Prescribing Guidelines

Policy Strategy Trends

Doctor Shopping Laws

CDC PHLP 2013

Tamper Resistant Forms

CDC PHLP 2013

Physical Exam Requirements

CDC PHLP 2013

Patient ID Requirements

CDC PHLP 2013

Pill Mill Laws

CDC PHLP 2013

Prescription Limits

CDC PHLP 2013

Immunity from Prosecution

CDC PHLP 2013

Prescribing Guidelines

Prescribing guidelines Washington – Rule Utah New Mexico Oklahoma NYC

ED prescribing guidelines Washington Ohio Oklahoma Arkansas Oregon Maine NYC

PDMPs and Health Information Technology

Interoperability Active – Alabama, Arizona, Connecticut, Florida, Illinois,

Indiana, Kansas, Kentucky, Louisiana, Maine, Michigan, New Mexico, North Dakota, Ohio, South Carolina, South Dakota, Virginia

In Process – California, Colorado, Delaware, Idaho, Massachusetts, Minnesota, Mississippi, Montana, Nevada, New Jersey, North Carolina, Rhode Island, Texas, Utah, Washington, West Virginia

EHR Integration Florida, Illinois, Indiana, Kansas, Maine, Ohio, Texas,

Washington, West Virginia

PDMP CoE at Brandeis University, NABP PMPi, MITRE Corp, SAMHSA

PDMP Proactive Reporting

PDMP CoE Brandeis University. 2013.

Top 10 Proposed Legislation

1. Immunity from prosecution laws and/or naloxone – 21 states

2. Required use/registration of PDMP – 13 states3. PDMP enhancements (access, reporting time,

delegates) – 11 states4. Creation of Commission or Working Group – 9 states5. Mandatory provider education on pain/addiction – 7

states6. Abuse-deterrent formulation substitution

restrictions – 6 states7. Opioid prescribing standards/rules – 5 states8. PDMP funding – 4 states9. OTP standards – 4 states10. Quantity/dose limits – 2 states

CQ State Tracker, CDC PHLP. 2013

Honorable Mentions

1. Alaska – required consultation with pain management specialist prior to prescribing ≥ 120 MME of an opioid

2. Iowa – promulgate rules/regulations on opioid prescribing in the ED

3. New Mexico – rescheduling hydrocodone4. West Virginia - Prohibit prescribing of

OxyContin or fentanyl unless the product also contains naloxone

CQ State Tracker, CDC PHLP. 2013

Conclusions

State level policies can significantly impact the prescription drug overdose epidemic

Many states are instituting similar policies…no need to recreate the wheel

Robust evaluations of policies and dissemination of findings are critical

Christopher M. Jones, PharmD, MPH

cjones@cdc.gov

Thank You

The findings and conclusions in this report are those of the author and do not necessarily represent the views of the Centers for Disease Control and Prevention.