Under a prescription drug monitoring program (PDMP), providers and pharmacists use an electronic database to track prescriptions for controlled substances, such as opioid medications. These PDMPs are intended to identify patients and behavioral health clients who may be misusing controlled prescriptions, which could put them at risk for addiction or overdose.
PDMPs allow users to collect, monitor, and analyze the data that pharmacies and providers submit regarding the prescription and dispensing of controlled prescriptions. States may use this information for research, education, and law enforcement.
The types of controlled substances included in PDMPs are based on federal and state laws for controlled substances. Most programs included medications listed on federal schedules II-IV. This may include:
Narcotics, such as hydrocodone
Tranquilizers, such as alprazolam and diazepam
Stimulants, such as methylphenidate
PDMPs are often used in collaboration with electronic prescribing for controlled substances (EPCS).
How should providers use a PDMP?
With a PDMP, clinicians are able to:
Identify clients and patients who may be obtaining prescriptions for controlled medications from multiple providers
Calculate the total amount of opioids prescribed to a client per day (in MME/day)
Identify individuals who are prescribed other controlled substances, such as benzodiazepines, that may increase the risk of opioids
The specific way you use your PDMP will depend on your state’s particular requirements, which may vary. However, the Centers for Disease Control and Prevention (CDC) recommends that clinicians check the PDMP at least once every 3 months, and before every opioid prescription.
If you have not yet begun using your state’s PDMP, check your individual state’s program to learn how to sign up. If your EHR solution offers e-prescribing, check with your vendor to see if you can integrate it with your state’s PDMP.
What if your client is flagged?
If your state PDMP indicates that your client is misusing controlled medications, it is important to take appropriate steps to protect their safety.
First, confirm that the information found in the PDMP is correct. Look for possible data-entry errors, signs of identity theft, or the use of an alternate name.
Once you have confirmed the information:
Do not immediately dismiss the client from your care.
If your client is receiving a high amount of medications, try to collaborate with him or her to taper down to a lower dosage or safer alternatives.
If there are high levels of opioids involved, consider offering naloxone or referring your client to the appropriate naloxone provider. You may consider offering or arranging for medication-assisted therapy.
Communicate the issue with your client’s other providers or caregivers.
If you or your client are concerned about opioid use disorder, discuss these safety concerns and all treatment options.
Discuss potential, non-medication options with your client, especially if there is chronic pain involved.
If you suspect diversion, consider using urine drug testing to determine whether opioids can be safely discontinued.
Always consider your client’s combined goals, needs, and risks when deciding how to approach the issue.
BestNotes EHR Solutions Offer PDMP
BestNotes EHR users can now access their state’s PDMP through BestNotes’ e-prescribing features. By pairing BestNotes’ e-prescribing capabilities with state PDMPs, you can continue to offer appropriate, high-quality care for behavioral health clients while remaining compliant with state, federal, and private mandates.
BestNotes EHR and CRM solutions are tailored specifically for mental health and addiction treatment providers, with e-prescribing and other medication management options. Contact us today to learn more.