Clinicians

Clinicians

• Co-prescribing Naloxone
• Continuing Education on Opioids
• Additional Resources

 Co-Prescribing Naloxone

On April 19, 2021, P.L. 2021, c.54 was signed into law, which requires a practitioner to co-prescribe an opioid antidote under certain conditions. If a health care practitioner issues a prescription for an opioid drug which is a controlled dangerous substance to a patient, the prescriber shall additionally issue the patient a prescription for an opioid antidote if any of the following conditions is present:

(a) the patient has a history of substance use disorder;

(b) the prescription for the opioid drug is for a daily dose of more than 90 morphine milligram equivalents; or

(c) the patient holds a current, valid prescription for a benzodiazepine drug that is a Schedule III or Schedule IV controlled dangerous substance.

A practitioner is not required to issue more than one prescription for an opioid antidote to a patient per year under this law. However, the law does not prohibit a practitioner from issuing additional prescriptions for an opioid antidote to a patient upon the patient’s request or when the practitioner determines there is a clinical or practical need for the additional prescription.

For more information, please visit: https://www.njleg.state.nj.us/2020/Bills/PL21/54_.PDF

The Surgeon General advises that prescribers, substance use disorder treatment providers and pharmacists learn how to identify patients at high risk for overdose, follow the CDC Guideline for Prescribing Opioids for Chronic Pain, and utilize the Prescription Monitoring Program (PMP). See U.S. Surgeon General’s Advisory on Naloxone and Opioid Overdose | HHS.gov.  Co-prescribing is also broadly supported by a multitude of U.S. health agencies, such as the FDA, the CDC and SAMHSA. The AMA Opioid Task Force encourages co-prescribing naloxone to a patient, family member or close friend of the patient, when clinically appropriate. The AMA released updated guidance to physicians for co-prescribing naloxone in August of 2017, and noted that the following factors may be helpful in determining whether to co-prescribe:

• Does the patient history or prescription monitoring program show that the patient is on a high opioid dose?
• Is the patient on a concomitant benzodiazepine prescription?
• Does the patient have a history of substance use disorder?
• Does the patient have an underlying mental health condition that might make him/her more susceptible to overdose?
• Does the patient have a medical condition, such as a respiratory disease, sleep apnea or other comorbidities, which might make him/her susceptible to opioid toxicity, respiratory distress or overdose?
• Might the patient be in a position to aid someone who is at risk of opioid overdose?

The AMA guidance offers additional suggestions on issues that may be discussed with the patient when determining whether to co-prescribe naloxone.  See AMA-Opioid-Task-Force-naloxone-one-pager-updated-August-2017-FINAL-1.pdf (end-opioid-epidemic.org)

Continuing Education on Opioids

Rowan University School of Osteopathic Medicine, in partnership with NJ CARES and the NJ Division of Consumer Affairs, offers CME on opioids for health care professionals with prescribing authority, and other licensees. This is an enduring recorded course series consisting of many modules that use a standardized, evidence-based opioid addiction prevention curriculum to train and inform New Jersey health care professionals on best practices in opioid prescribing and patient care in compliance with federal and state statutory and regulatory guidelines. The modules are designed to educate New Jersey health care professionals with prescribing authority, including physicians, physician assistants, dentists, podiatrists, optometrists, certified nurse midwives, and advanced practice nurses, as well as licensed pharmacists, psychologists, social workers, professional counselors, marriage and family therapists, and registered nurses and athletic trainers. 

For more information and to register, you may visit: http://bit.ly/njcaresmodules

In addition, Rowan University School of Osteopathic Medicine partnered with the NJ Department of Health to develop three virtual modules to train and inform New Jersey dentists, dental specialists, and dental professionals on best practices in opioid prescribing, pain management strategies, and referral to medication-assisted treatment (MAT) in compliance with federal and state statutory and regulatory guidelines.

For more information and to register, you may visit:  RowanSOM — RSDM — HRSA — NJ DOH Opioid Dentistry Education Training | Rowan Online Marketplace

Additional Resources

Division of Consumer Affairs Waivers during the COVID-19 Public Health Emergency
COVID-19 Healthcare Licensees (njconsumeraffairs.gov)

CDC Opioid Prescribing Guidelines
CDC Guideline for Prescribing Opioids for Chronic Pain | Drug Overdose | CDC Injury Center

Sample Pain Management agreement from the New Jersey State Board of Medical Examiners
Pain Treatment with Opioid Medications: Patient Agreement

Unsafe Storage of Opioids-Risks to Children
https://www.nj.gov/dcf/news/publications/Opioids.and.Children.Alert.pdf