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Opioid Prescribing Safety
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THE PROBLEM

The impact of opioid misuse is significant in our communities and on the public health system. On June 1, 2017, the Arizona Department of Health Services (ADHS) released its latest data on opioid overdoses in Arizona showing the highest number of deaths in ten years. In 2016, 790 Arizonans died from opioid overdoses. The trend shows a startling increase of 74 percent over the past four years.

The 2016 opioid report shows over half of the 1,497 drug overdose deaths in that year were due to opioids as the primary cause of death. Opioids include heroin as well as prescription medication. The number of heroin deaths alone has tripled since 2012.

Research has found that approximately 3 out of 4 new heroin users report having abused prescription opioids prior to using heroin. Heroin is an opioid, and both drugs act on the same receptors in the brain to produce similar effects.

OPIOID ABUSE EPIDEMIC IN ARIZONA

On June 5, 2017, Governor Ducey declared a state of emergency in response to the opioid abuse epidemic in Arizona. While the state of emergency timeframe has ended, important reporting changes remain in effect. Visit azhealth.gov/opioid to keep up with the latest recommendations for clinicians.

EFFECTIVE OCTOBER 16, 2017: All prescribers are required to obtain a patient utilization report from the Controlled Substances Prescription Monitoring Program (PMP) prior to prescribing an opioid analgesic or benzodiazepine controlled substance. It is the prescriber’s responsibility to understand the new law and the requirements. Learn more at the PMP website.

ArMA and the Arizona Osteopathic Medical Association (AOMA) have created a compliance checklist resource: it can be downloaded here: CSPMP Compliance Checklist!

Current rules still require reporting of certain opioid-related events. Required reporters include the following:
• Healthcare professionals licensed under A.R.S. Titles 32 & 36, including physicians, are required reporters.
• Administrators of a healthcare institution or correctional facility
• Medical examiners
• Pharmacists
• Emergency Medical Services/Ambulance agencies (first response agencies, ground and air ambulance agencies)
• Law enforcement officers

Health conditions to be reported by physicians and other healthcare professionals under A.R.S. Title 32:
• Suspected opioid overdoses
• Suspected opioid deaths
• Neonatal abstinence syndrome

Reporting System: Required reporters, including physicians, must use MEDSIS, for reporting the above listed health conditions. MEDSIS is the communicable disease reporting system, and it has been amended with new reporting fields.

MEDSIS Training is available at www.azhealth.gov/opioidtraining.

Need to set up a MEDSIS account? Contact MedsisHelpDesk@siren.az.gov.

WHAT PHYSICIANS AND OTHER CLINICIANS CAN DO NOW

Here are immediate steps physicians can take to help our patient populations.

ADDITIONAL RESOURCES