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    Maryland Prescription​ Drug Monitoring Program​ Updates

    ​Expanding Access to Buprenorphine

    ​Effective December 29, 2022 the DATA 2000 waiver is no longer required to prescribe buprenorphine for opioid use disorder (OUD). The fiscal year 2023 omnibus, signed by President Biden on December 29, 2022, removes the federal requirement to obtain a waiver prior to prescribing buprenorphine for OUD. Only a DEA number is needed. All practitioners who have a current DEA registration that includes Schedule III authority, may now prescribe buprenorphine for opioid use disorder. Click here​ for more information.

    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 were promulgated in May 2023.  The PDMP Advisory Board has given dispensers an implementation period to operationalize the new naloxone reporting requirement until July 20, 2023.  If a prescriber writes a prescription for naloxone and does not have a DEA number, then the dispenser should provide the prescriber's NPI number.  As a reminder, these naloxone dispenses will not be viewable in the PDMP; the data will be used in aggregate for public health surveillance and planning.  Here is the updated RxGov PDMP Data Submitter Guide.

    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®) 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 10.4​7.07

    Morphine Milligram Equivalents (MME) Added to PDMP

    On February 25, 2020, morphine milligram equivalents (MME) 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​