DORA contributes to state’s effort to give healthcare providers tools to treat pain and combat prescription drug abuse
DENVER. - (Oct. 15, 2015) - Enough opioid painkillers are dispensed in Colorado to supply every adult with one pill every hour of every day for an entire month. Overdose deaths from opioid painkillers claim the lives of 300 Coloradans each year.
“Many people think these drugs are safe because their healthcare practitioner prescribed them. But their effects can be just as potent as illicit drugs such as heroine,” said Lauren Larson, Director of Division of Professions and Occupations, which houses 28 of the state’s healthcare regulatory boards and programs at the Department of Regulatory Agencies (DORA).
The alarming rate of prescription drug misuse in the State has prompted DORA to take action by boosting the State’s Prescription Drug Monitoring Program (PDMP) and facilitating common opioid guidelines for all practitioners in addition to expanding access to care.
“DORA and the boards it houses exist for consumer protection. We have a dual obligation to help practitioners compassionately treat pain while addressing the prescription drug abuse crisis in our state,” said Larson. “We are already seeing practitioners respond to the call.”
For example, increasing usage of the PDMP, a statewide database of all controlled substances dispensed in the state which licensed prescribers and dispensers can access regarding their patients, has helped lead to a decrease in doctor-shopping for prescription drugs statewide.
This time last year, the PDMP sent over 600 notifications to prescribers and pharmacies in the State, alerting them that a patient they treat obtained potentially dangerous amounts of controlled substances from multiple prescribers and pharmacies.
In one instance, a patient obtained prescriptions from 11 different prescribers and 10 different pharmacies within 30 days, amounting to potentially harmful quantities of potent prescription drugs. Another person obtained over 1,600 pills of oxycodone and hydrocodone from multiple prescribers and dispensers in one month.
In September, the database sent only 228 notifications: less than half the number of “push-notices” sent this time last year. Notably absent are instances of doctor-shopping witnessed in 2014 evidencing undetected addiction and diversion.
The decrease has occurred amid increased awareness and use of the PDMP by prescribers and pharmacists. Overall, use of the PDMP rose to 92 percent, a 74 percent increase over the 53 percent rate in October 2014.
While prescribers and pharmacists are not required to act when they receive informational push-notifications, they are asked to use their clinical judgment in determining an appropriate response and consult “The Policy for Prescribing and Dispensing Opioids.” These common guidelines were issued by the healthcare boards last year for practitioners engaged in opioid therapy - from dentists to nurses with prescriptive authority - marking a first for the nation in which multiple healthcare boards, which usually work autonomously, collaborated to draft a joint policy.
“The number of patients seeking pain management exceeds the number of pain specialists in the state which is why Colorado needs all practitioners working on the same playing field for opioid therapy. This policy educates primary care and other providers broadly with the information they need to achieve the appropriate relief the patient requires,” said Larson.
The policy is just one of many steps DORA has undertaken to expand access to care. Its Telehealth Symposium hosted in February 2015 allowed board members to discuss guidelines for practitioners using new technologies to reach remote patients.
DORA also sponsored a bill this year that lowered requirements for advanced practice nurses (APNs) to obtain prescriptive authority - a profession that plays a vital role in primary care, serving many rural and underserved urban areas of the State.
“We can’t solve the state’s prescription drug abuse problem alone - nor should that burden fall on the practitioner’s shoulders. The PDMP and Opioid Policy are just part of a multi-pronged approach lead by the Colorado Consortium for Prescription Drug Abuse Prevention. Today, we’re thrilled to engage the Consortium members at their annual meeting for their feedback on our efforts and the opportunities they see on the horizon,” said Larson.