Opioids: Prescribing & Monitoring

An ongoing problem with prescription opioids includes the state of Washington. This prompted two recent actions. The first happened in October 2016 when Governor Inslee signed Executive Order 16-09. In that order, he characterized opioid use disorder as “a devastating and life-threatening medical condition.” He also called for actions to reduce opioid misuse and abuse.

The second action happened during the 2017 legislative session. The legislature considered several bills to address the issue of opioid use disorder. Ultimately, the legislature passed Engrossed Substitute House Bill (ESHB) 1427 and the governor signed it into law.

As part of the implementation of 1427, there will be a series of seven workshops held around the state to implement ESHB 1427. The first of these is scheduled for:

September 20th, 9 am:
Capital Event Center
6005 Tyee Dr SW, Tumwater, WA 98512
Wednesday, September 20 in the Chehalis AB Room
Map/Directions

The objectives for the workshops are in two parts:

For the boards and commissions, representatives from the five boards and commissions (see sidebar) will form a workgroup to create prescribing rules, much as they did in 2011 for the chronic non-cancer pain rules.

This workgroup’s key aims are to:

• Generate a boilerplate set of prescribing rules;
• Create uniform recommendations on revising existing pain management rules;
• Forward the boilerplate rules to each board and commission to adopt under their own authority; and
• Coordinate education and outreach campaigns.

For the PMP reporting and metrics:

• Establish an overdose notification message for providers;
• Determine the information and metrics to be provided to facilities, groups, and the Washington State Hospital Association;
• Create formats and metrics for prescriber feedback reports; and
• Develop communication and technical assistance.

The deadline for the boards and commissions to adopt their rules is January 1, 2019. The PMP plans to complete its work during this same time.

The seven workshop meetings are open public meetings. The public is welcome to attend and will have an opportunity to give comments. Another notice will come out soon with the other dates and locations.

Effects of ESHB 1427

• Expanding access to PMP data to government, including personnel within the Department of Health (department), the Health Care Authority, and local health offices.
• Sharing PMP data with health care facilities and groups of at least five prescribers.
• Allowing hospitals to receive PMP data through their continuous quality improvement programs.
• Directing the department to develop an overdose-event notification letter to be sent to prescribers when these events occur.
• Creating a feedback reporting mechanism for providers of their prescribing practices in comparison to others in similar practice specialties.
• And finally, it directs the following boards and commissions to create prescribing rules for using opioids for acute, subacute and perioperative pain (which may include making changes to the existing chronic non-cancer pain rules):
• Board of Osteopathic Medicine and Surgery;
• Dental Quality Assurance Commission;
• Medical Quality Assurance Commission;
• Nursing Care Quality Assurance Commission; and
• Podiatric Medical Board.

The boards and commissions must consider the revised Agency Medical Directors Group and Centers for Disease Control guidelines; and consult with their professions’ associations, the Department of Health, and the University of Washington.

August 2nd, 2017

Important points of Executive Order 16-09:

• Applying safe prescribing practices;
• Giving more consideration to non-opioid choices to manage pain;
• Increasing access to medication-assisted treatment; and
• Increasing the use of Washington's Prescription Monitoring Program (PMP)
• A website will be established where interested persons can get information on the of implementing ESHB 1427.

Questions and comments may be sent via email to: painmanagement@doh.wa.gov

Contact:
Megan Mikkelsen
Department of Health
360-236-4617