What You Need to Know About New Prescribing Regulations

Doctors, pharmacists and patients impacted. 

The misuse of prescription drugs is a national public health crisis that affects patients and their families from all backgrounds. The misuse of opioid painkillers alone is estimated to cost $78.5 billion a year, which includes costs for health care, lost productivity and addiction treatment, according to the Centers for Disease Control and Prevention. Fatal overdoses due to opioids were five times higher in 2016 than 1999.

We are committed to doing our part to confront this crisis and advance better practices for pain management for our patients. In 2016 we launched a major initiative to reduce by 40 percent the number of opioid pills and patches prescribed to patients over a three-year period. To date, we’ve made significant progress. We’ve reduced the number of prescribed opioid pills and patches by 19 percent, which equates to nearly 490,000 fewer pills and patches.

Our work, however, reflects just one part of the community’s response to this important health care issue. The state of Michigan recently enacted a series of news state laws regulating the prescribing and dispensing of controlled substances including opioid painkillers. These laws have implications for doctors, pharmacists and patients. Here’s what you need to know:

• Starting June 1, 2018, people who prescribe controlled substances — doctors, pharmacists, dentists and veterinarians – must register with the Michigan Automated Prescription System (MAPS) before they can prescribe or dispense a controlled substance or opiate painkiller.
  • MAPS is the state’s prescription drug monitoring program. It is a valuable resource for prescribers to identify patients who may be at risk from these potent medications. It also enables doctors and pharmacists to quickly identify all the controlled substances used by a patient. MAPS will also help identify patterns of abuse, suspicious prescribing, doctor-shopping and pharmacy shopping by patients.
  • A doctor must review a patient’s history on MAPS before prescribing any controlled substance that exceeds a three-day supply.
• Starting June 1, 2018, patients who receive an opiate painkiller must receive opioid education before a prescription is given. Patients must also sign a consent form acknowledging they received the education.
  • This opioid education includes risks and side effects of opioids, as well as safe storage and disposal. It must be repeated for different episodes of care or for new medications.
  • The consent form, developed by the state, is called Opioid Start Talking. Once signed, it will be included in the patient’s medical record. For those under age 18, their parent or legal guardian must receive the education before their child receives their prescription. Only a parent or legal guardian can sign the Opioid Start Talking form for a minor.
  • The Opioid Start Talking form comes in three languages: English, Arabic and Spanish.
• Starting July 1, 2018, a doctor treating a patient for acute pain can only prescribe a maximum seven-day supply of opioid pills within a seven-day period. Acute pain is defined as normal pain associated with an invasive procedure, trauma or disease that typically lasts for a limited amount of time.
• Henry Ford patients can request prescription refills through either their MyChart account or by calling their doctor’s office. However, additional education may be required if your care or your prescription changes.
• The new laws target commonly prescribed opiate painkillers such as Vicodin, morphine, oxycodone, Tylenol with codeine and tramadol. Commonly prescribed controlled substances are Adderall, Xanax, valium and Ritalin.

Managing your pain safely

As part of our commitment to providing compassionate, appropriate and safe pain management, we have enhanced our clinical practices for patients. This includes:

• Standardized written guidelines for pain management and opioid reduction for non-cancer pain, including addiction assistance and counseling.
• Education programs for providers and clinical staff.
• An analytics tool for evaluating prescribing practices.
• Standardized patient protocols in primary care clinics for pain assessment, opioid assessment, urine toxicology screening and patient opioid contacts.
• Expanded behavioral health services and embedding behavioral health experts in primary care clinics.
• Expanded pain management services including alternative non-medication approaches such as acupuncture and physical therapy.

For questions or concerns about your opioid prescription, contact your doctor who prescribed your pain medication. If you think you may have an opioid addiction or are concerned about a family member’s opioid use, call our Behavioral Health Services at (800) 422-1183 or visit www.henryford.com/OpioidAddiction.