Virginia is experiencing a substance use crisis of overwhelming proportions. Across the Commonwealth, 986 people died due to fatal drug overdoses in 2014. Nearly 80% of these deaths involved prescription opioids or heroin. The Virginia Department of Health reported a 38% increase in deaths from prescription opioid and heroin overdoses between 2012 and 2014 with fatal drug overdoses occurring in counties and cities across Virginia (see below).
The Governor’s Task Force on Prescription Drug and Heroin Abuse in Virginia proposed numerous recommendations to the Administration that were designed to strengthen the Prescription Monitoring Program (PMP) and to support providers in proper prescribing and dispensing practices. Recognizing that diversion of prescribed opiates is a major contributor to the overdose epidemic, legislation to require hospice settings to notify pharmacies of a patient’s death was also passed. Additionally, an existing regional pilot that made naloxone available to first responders was expanded statewide by the General Assembly; the same piece of legislation created an avenue to allow pharmacists to dispense naloxone under proper protocols.
In the 2016 General Assembly session, several bills were passed that focused specifically on the utilization of the PMP for both prescribers and dispensers. As of July 1, 2016, Virginia law now mandates the points below.
- Prescribers MUST check Virginia’s Prescription Monitoring Program (PMP) before writing opioid prescriptions longer than 14 consecutive days.
- Prescribers of opioids meeting a certain threshold MUST receive Continuing Medical Education (CME) in how to prescribe such drugs appropriately, and
- Medicaid MCOs may access PMP to identify members with behaviors suggesting opioid abuse or misuse.
FDA warns about serious risks and death when combining opioid pain or cough medicines with benzodiazepines; requires its strongest warning Safety Announcement
[8-31-2016] A U.S. Food and Drug Administration (FDA) review has found that the growing combined use of opioid medicines with benzodiazepines or other drugs that depress the central nervous system (CNS) has resulted in serious side effects, including slowed or difficult breathing and deaths. Opioids are used to treat pain and cough; benzodiazepines are used to treat anxiety, insomnia, and seizures. In an effort to decrease the use of opioids and benzodiazepines, or opioids and other CNS depressants, together, we are adding Boxed Warnings, our strongest warnings, to the drug labeling of prescription opioid pain and prescription opioid cough medicines, and benzodiazepines.
Additional Resources
- ARTS Postcard
- Substance Use Disorder Member Release of Confidential Information Consent Form
- Strategies to Address Prescription Drug Abuse
- ASAM MAT National Practice Guidelines
- CDC Opioid Prescribing Guidelines
- CDC Guidelines at a glance
- COWS induction flow sheet
- CDC Opioid Prescribing checklist
- Va Premier ARTS Disclosure Form Revocation
- Non-Opioid alternative treatments – CDC
- Substance Use Disorder – OPG Guidelines
- Opioid Benzos Tapering Flowchart
- Opioid Morphine EQ Conversion Factors
- SAMSHA OPIOID Overdose Toolkit
- Tips for Friends and Families-English
- Key Approaches
- CMS Best Practices for Opioid Misuse
- Surgeon General Pledge
- FDA Safety Announcement – Opioids and Benzodiazepines
Source: VCU Department of Health Behavior and Policy.
Available at http://hbp.vcu.edu/media/hbp/policybriefs/pdfs/Senate_OpioidCrisisPolicyBrief_Final.pdf. Accessed May 9, 2017.
