Seeking to combat a growing epidemic of prescription drug abuse in New Mexico, the state Board of Pharmacy voted Thursday to strengthen an existing monitoring program that tracks drug prescriptions, who dispenses them and under what circumstances.
Other rule changes adopted by the board, which will go into effect later this year, will require additional training for pharmacists on how to use that monitoring system, limit the supply of drugs prescribed in certain situations and tighten language regarding penalties for anyone lawfully allowed to dispense prescription drugs who withholds or falsifies information going into the tracking system.
"We're accomplishing great things by educating pharmacists," Danny Cross, a board member and pharmacist, said during a well-attended, two-hour hearing Thursday at the board's Albuquerque headquarters. "This is not punishing pharmacists. This is to educate pharmacists, practitioners and patients ... to help control this drug abuse problem."
Over the past decade, New Mexico has experienced a spike both in the number of pills being prescribed and the number of drug overdose deaths reported. From 2001 to 2010, the sales of opioid pain relievers rose by 131 percent in the state, from 489,809 grams to 1.13 million grams, according to the state Department of Health. Meanwhile, over roughly the same period, the state's drug overdose death rate increased by 79 percent -- from the 261 people who died in 2001 to the 468 who lost their lives in 2010.
The epidemic, of course, is not confined to New Mexico. Nationwide, the National Survey on Drug Use and Health estimated that in 2010, 7 million people used prescription drugs nonmedically.
But New Mexico's rate of drug overdose deaths is the highest in the nation.
Even some of the state's pharmacists don't understand the size of the problem, Dale Tinker told board members Thursday.
"It's a lot bigger issue than I think they thought," Tinker, a lobbyist for the New Mexico Pharmacists Association, said.
Tackling the prescription drug abuse problem is complex because it involves multiple challenges. Emergency rooms might see addicts looking for their next fix or dealers trying to corral a new supply, but they also come into contact with patients who want to get off the drugs and don't know where else to turn.
One of the challenges is to ensure that those who are handed a white bag with a bottle of pills inside are the people who truly need it. Another is ensuring that those who hand the prescribed drugs to individuals have access to up-to-date information that the prescription is appropriate.
The rules adopted Thursday represent an attempt to address those problems, mostly by ensuring pharmacists and pharmacist interns are better armed with information on how to prevent abuse and stop addiction before it starts, officials said.
One of the changes would give New Mexico's pharmacists the ability to request from the state's prescription monitoring system a report detailing the past year of a patient's history if he or she exhibits signs of potential abuse or misuse of opiate drugs or if the prescription order is from a dispenser with whom the pharmacist is unfamiliar.
Also under the new rules, practitioners including doctors, dentists, veterinarians, pharmacists and certified nurse practitioners would have to register and train for the state's monitoring program when they complete their controlled-substance registration.
That electronic database gives doctors and pharmacists access to a patient's prescription-drug history. Providers update the information at least every seven days -- an improvement over the monthly updates that were previously all that was required.
"It's a message from the board," said Bill Harvey, the Board of Pharmacy's director. "It's about professional expectations."
The board also voted to require that any controlled-substance prescriptions that go directly to a patient could not be refilled before 75 percent of the days have passed since the prescription was filled, unless a doctor approves the refill. Similarly, prescriptions that go to a patient indirectly, such as through a mail-order service, couldn't be refilled until 66 percent of the days in a 90-day supply have gone by, or half of the days in a 30-day supply, unless a doctor authorizes the refill.
Another change would limit new over-the-phone prescriptions for some controlled substances to a 10-day supply that cannot be refilled. Currently, a phone prescription for those drugs can be refilled up to five times in six months.
Board members seemed intent on adopting the changes Thursday despite potential obstacles.
"We're trying to get things in place sooner rather than later," board member Buffy Saavedra said at one point when someone in the audience asked a question that appeared not to be answered in the proposed rules.
At another point, the board learned that a proposed change would bar the state from qualifying for future U.S. Drug Enforcement Administration funding for the state's prescription monitoring program.
The change under consideration would allow individual pharmacists to access and use the state's prescription monitoring program instead of circumscribing access only to pharmacies, which the DEA requires for a state to qualify for certain types of funding. Many pharmacies employ more than one pharmacist, officials pointed out Thursday. And by having individual pharmacists register to use the system, New Mexico officials believe the state can better track potential abuse.
"This is a big enough problem" that the board should go ahead with the change despite the potential loss of future federal funding, pharmacy board chairman Richard Mazzoni said.
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