________________________________ Substance Use Disorders and Pain Management: MATE Act Training
Controlled Substances Laws/Rules The DEA is responsible for formulating federal standards for the handling of controlled substances. In 2011, the DEA began requiring every state to implement electronic databases that track prescribing habits, referred to as PDMPs. Specific policies regarding controlled substances are administered at the state level [171]. According to the DEA, drugs, substances, and certain chemi- cals used to make drugs are classified into five distinct categories or schedules depending upon the drug’s acceptable medical use and the drug’s abuse or dependency potential [172]. The abuse rate is a determinate factor in the scheduling of the drug; for example, Schedule I drugs are considered the most dangerous class of drugs with a high potential for abuse and potentially severe psychologic and/or physical dependence. State-Specific Laws and Rules Most states have established laws and rules governing the prescribing and dispensing of opioid analgesics. It is each prescriber’s responsibility to have knowledge of and adhere to the laws and rules of the state in which he or she prescribes. CONCLUSION Substance use disorders are associated with serious morbidity and mortality, and advances in the understanding of these disorders have led to the development of effective treat- ments. More recently, the abuse of prescription opioids has become considerably more widespread, fueled in part by the availability of such drugs over the Internet. Medical, mental health, and other healthcare professionals in a variety of set- tings may encounter patients with comorbid substance use disorders and pain. The knowledge gained from the contents of this course can greatly assist the healthcare professional in identifying, treating, and providing an appropriate referral to patients with substance use disorders while also addressing pain management needs.
Patients with chronic pain found to have an ongoing substance abuse problem or addiction should be referred to a pain spe- cialist for continued treatment. Theft or loss of controlled substances is reported to the DEA. If drug diversion has occurred, the activity should be documented and a report to law enforcement should be made [169].
COMPLIANCE WITH STATE AND FEDERAL LAWS
In response to the rising incidence in prescription opioid abuse, addiction, diversion, and overdose since the late 1990s, the FDA has mandated opioid-specific REMS to reduce the potential negative patient and societal effects of prescribed opioids. Other elements of opioid risk mitigation include FDA partnering with other governmental agencies, state professional licensing boards, and societies of healthcare professionals to help improve prescriber knowledge of appropriate and safe opioid prescribing and safe home storage and disposal of unused medication [153]. Several regulations and programs at the state level have been enacted in an effort to reduce prescription opioid abuse, diver- sion, and overdose, including [170]: • Physical examination required prior to prescribing • Tamper-resistant prescription forms • Pain clinic regulatory oversight • Prescription limits • Prohibition from obtaining controlled substance prescriptions from multiple providers • Patient identification required before dispensing • Immunity from prosecution or mitigation at sentencing for individuals seeking assistance during an overdose
WORKS CITED https://qr2.mobi/mate-act
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