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    Maryland Prescription​ Drug Monitoring Program​ Updates

    ​​Naloxone Medication Data

    ​In the Maryland 2022 Legislative Session, Chapter 224 "Public Health – Prescription Drug Monitoring Program (PDMP) – Naloxone Medication Data" passed.  What this means is that dispensers who currently report CDS dispenses to the PDMP will also begin reporting naloxone dispenses to the PDMP.  The bill gave the start date of October 1, 2022; however, the regulations to guide this change have not yet been promulgated.  After the regulations have been promulgated, the PDMP will update the MD PDMP RxGov Data Submitter Reference Guide which will include guidance to dispensers on submitting naloxone dispenses and a date for the change to go into effect.​


    Educational Notifications for Providers

    In January 2022, the PDMP will begin the process of transitioning to electronic notifications.  Information on the different types of educational notifications sent to providers can be found here​.  The notifications, also referred to as Unsolicited Reporting Notifications or URNs, are provided for educational and practice improvement purposes with the goal of supporting clinical decision-making and reducing the risk of adverse outcomes for patients receiving CDS prescriptions.  Currently these notifications are sent by mail based on the providers address submitted to the DEA.


    Naloxone Co-Prescribing Regulations

    Newly promulgated Maryland regulations (COMAR 10.13.03) support the co-prescribing of naloxone, the opioid overdose reversal agent, to these patients. See the Naloxone Co-Prescribing​​ fact sheet​ for additional information. 
    Naloxone (NARCAN®, EVZIO®) is a prescription medication that safely and effectively reverses an opioid overdose. Naloxone does NOT: “enable” someone's drug use, have “street” or resale value, or make a prescriber liable for a patient’s overdose. Medical providers can prescribe naloxone directly to patients, become an ORP to certify patients and provide naloxone through a standing order, or refer patients to a local ORP training.

    Effective October 1, 2022 Senate Bill 200 requires the Prescription Drug Monitoring Program (PDMP) to monitor the dispensing of all naloxone medication by prescribers and dispensers in Maryland.  This change requires that all dispensers report naloxone medication data to PDMP with the same frequency that they report controlled substance medication data.  Naloxone medication data will not be available, except as de-identified data for use in public health surveillance, research, public reporting and education.  Changes to the regulations are pending.  The changes that were passed in can be viewed here:  SB 200.
    The current regulations can be viewed here:  COM​AR 10.47.07

    New Tapering Guidance

    The federal Department of Health and Human Services (HHS) published a new opioid tapering guidance document for clinicians October 2019.The Guide for Appropriate Tapering or Discontinuation of Long-Term Opioid Use provides new guidance on safe and effective tapering practices and discontinuation of opioid therapy.  

    The HHS Guide for Appropriate Tapering or Discontinuation of Long-Term Opioid Use includes the following recommendation: Health care professionals should not abruptly discontinue opioids with a patient who is physically dependent. Rapid discontinuation can result in uncontrolled pain or withdrawal symptoms, and these symptoms can lead patients to seek other sources of opioid pain medicines, which may be confused with drug-seeking for misuse. Patients may attempt to treat their pain or withdrawal symptoms with illicit opioids or other substances. When tapering, create a patient specific plan to gradually taper the dose of the opioid and ensure ongoing monitoring and support to avoid serious withdrawal symptoms, worsening of patient’s pain, or psychological distress.​

    Morphine Milligram Equivalents (MME) Added to PDMP

    On February 25, 2020, morphine milligram equivalents (ME) were added to the PDMP. MME converts prescription opioids into a standard value that is based on morphine. MME is intended to help clinicians make safe, appropriate decisions while managing pain. For more information please view the following resources:
    CDC Webinar on Dosing and Titrating Opioids: https://emergency.cdc.gov/coca/calls/2016/callinfo_081716.asp​
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