Because treatment need is often not met with sufficient MAT resources, prescribers should consider undergoing training and obtaining a waiver from the Substance Abuse and Mental Health Services Administration (“SAMHSA”) to provide
buprenorphine to treat opioid use disorder in an office setting. (See the Appendix for resources related to MAT and obtaining a waiver from SAMHSA).
APPENDIX A.1
PDMP Colorado Prescription Drug Monitoring Program (PDMP): https://www.colorado.gov/dora-pdmp Please note, pursuant to SB-1746, Access to Prescription Drug Monitoring Program, authorized use of the PDMP was expanded effective April 6, 2017, to include the following: ● Prescribers are authorized to query the PDMP about a current patient, regardless of intent to prescribe controlled substance, thus making the PDMP an even more useful tool for health professionals in their clinical decision-making for patients; Preventing diversion through appropriate disposal In order to prevent diversion, providers should provide information regarding appropriate disposal, including the following: ● Securing unused prescription opioids until such time they can be safely disposed. Specifically, ensure that prescription opioids are not readily accessible to other family members (including adolescents and/or children) or visitors to the home. ● Take-back events are preferable to flushing prescriptions down the toilet or throwing them in the trash. Only some medications may be flushed down the toilet. See the FDA’s guidelines for a list of medications that may be flushed: www.fda.gov ● Utilize take-back events and permanent drop box locations www.colorado.gov/pacific/cdphe/ colorado-medication-take-back-program ● Utilize DEA disposal guidelines if take-back or drop boxes are unavailable. Those guidelines include: Record keeping Prescribers who treat patients with opioids should maintain accurate and complete medical records according to the requirements set forth by their licensing board. The medical record should include, but is not limited to, the following: ● Copies of the signed informed consent and treatment agreement; ● The patient’s medical history; ● Results of the physical examination and all laboratory tests; ● Results of the risk assessment, including results of any screening instruments used; ● A description of the treatments provided, including all medications prescribed or
● Veterinarians are authorized to query the PDMP about a current client if the veterinarian has a reasonable basis to suspect the client has committed drug abuse or has mistreated an animal; and ● Pharmacists are authorized to query the PDMP about a current patient for whom the pharmacist is dispensing any prescription drug, rather than wonly patients receiving controlled substances. Please note, pursuant to SB18-022, Clinical Practice for Opioid Prescribing, statutory limitations have been placed on the prescribing of opioids for pain that has not been treated with opioids in the previous 12 months. ○ Take the drugs out of their original containers and mix them with an undesirable substance, such as used coffee grounds or kitty litter; then put them in a sealable bag, empty can, or other container to prevent the medication from leaking out of a garbage bag; ○ Before throwing out a medicine container, tell the patient to scratch out all identifying information on the prescription label to protect their identity and personal health information; and ● Educate patients that prescriptions are patient specific. Patients may not share prescription opioids with friends, family or others and may pose serious health risks, including death. ● Use activated charcoal absorption technologies to inactivate unused medications or used fentanyl patches. administered (including the date, type, dose and quantity); ● Instructions to the patient, including discussions of risks and benefits with the patient and any significant others; ● Results of ongoing monitoring of patient progress (or lack of progress) in terms of pain management and functional improvement; ● Notes on evaluations by and consultations with specialists; ● Results of queries to the state PDMP; ● Any other information used to support the initiation, continuation, revision, or termination of treatment and the steps taken in response to any aberrant medication use behaviors.
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Book Code: MDCO1025
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