Announcements

Hello! I am writing to let you know about a new webinar series I am leading with the NYC Department of Health, focused on clinical use of PDMPs. Please forward to your colleagues. Thank you! 
Joanna
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Dear Colleague,  

Overdose death in the United States continues to climb during the ongoing COVID-19 pandemic. Recent provisional data from the Centers for Disease Control and Prevention (CDC) show that over 81,000 drug overdose deaths occurred across the country in the 12 months ending in May 2020—higher than any previously recorded 12-month period. The CDC recommends that clinicians co-prescribe naloxone to patients with high morphine milligram equivalents and those receiving opioids and benzodiazepines. Prescribers such as physicians, nurse practitioners, and physician assistants can help by optimizing how we use prescription drug monitoring programs (PDMPs) in clinical care.  

Starting Tuesday, March 30, the New York City Department of Health and Mental Hygiene, in partnership with Montefiore Medical Center and NYC Health + Hospitals, will host a series of webinars with practical and current guidance for health care providers to optimize use of PDMP data in clinical care. The presentations were developed by a team of experts and include case-based discussions highlighting common and challenging case scenarios. Topics for the eight CDC Overdose Data to Action (OD2A)-funded webinars will cover: a history, overview, and importance of using PDMPs; prescribing opioids for inherited patients; equity and racial bias in opioid prescribing; prescribing for patients with complex medical histories; and more. Continuing Medical Education (CME) credits (or equivalent) will be offered with each webinar.  

Key points and recommendations:  

1. Clinical practice guidelines encourage use of the PDMP prior to prescribing Schedule II-IV controlled substances, including opioids, benzodiazepines, other sedative-hypnotics (e.g. zolpidem), and pregabalin. 
2. PDMP data can help prescribers to: verify prescription fills (e.g., dates and quantity), review trends in prescription fills, identify patients at high risk for substance use disorder or overdose, guide collaboration with other prescribers and patients, and identify activity suggesting diversion or fraud.   
3. Incorporating PDMP data into clinical decision-making should be guided by several principles: 
1. PDMP data provide objective data that must be interpreted in context. 
2. Decisions about whether and how to prescribe should consider the broader risks and benefits to the individual patient. 
3. Avoid abrupt discontinuation or dose reduction of controlled substances that would result in severe withdrawal symptoms. These could lead to illicit use, overdose, seeking emergency care, dysphoric mood, and suicide risk. For some medications including benzodiazepines, it could result in seizures or death. 
4. Assess patients taking controlled substances for substance use disorder. 
5. Substance use disorders, including opioid use disorder, are chronic illnesses that require long-term treatment. All patients with substance use disorder should be provided or referred for evidence-based treatment. Treatment for opioid use disorder is effective, safe, and available throughout the country. 
6. Communication with patients about pain and substance use can take place in a way that preserves and improves the therapeutic relationship with patients. This includes using active listening, validating, using non-stigmatizing language, and using shared decision-making.  

These principles and others will be addressed in the webinar series (see accompanying information), along with practical tips for implementing them in patient care. We hope you can join us for one or more of the webinars.  

Thank you,  

NYC DOHMH 

Click here to register for the first webinar in the Optimizing Provider Use of Prescription Monitoring Programs series.

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