Guideline for Prescribing Opioids For Chronic Pain Assignment

Guideline for Prescribing Opioids For Chronic Pain Assignment

Purpose
The purpose of this assignment is to provide the student with an opportunity to explore the most recent guidelines and recommendations in the student’s state of practice for pain management therapies and education; as well as to understand specific state regulations governing controlled substance prescriptions and medical devices.

Activity Learning Outcomes
Through this assignment, the student will demonstrate the ability to: Guideline for Prescribing Opioids For Chronic Pain Assignment

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Identify and describe at least one current state specific guideline for pain management therapy and education.
Explore other organizations or pain initiatives that are offered by the state (if applicable) and federal bodies.
Describe state specific laws that apply to the authority to prescribe controlled substances and medical devices.
Explore the state’s Prescription Drug Monitoring Program (PDMP).
Due Date:
Assignment should be submitted to the Week 2 State Specific Guidelines for Prescribing Controlled Substances & Medical Devices dropbox by Sunday 11:59 p.m. MST at the end of Week 2.

This assignment will follow the late assignment policy specified in the course syllabus.

Students are expected to submit assignments by the time they are due. Assignments submitted after the due date and time will receive a deduction of 10% of the total points possible for that assignment for each day the assignment is late. Assignments will be accepted, with penalty as described, up to a maximum of three days late, after which point a zero will be recorded for the assignment Guideline for Prescribing Opioids For Chronic Pain Assignment.

In the event of a situation that prevents timely submission of an assignment, students may petition their instructor for a waiver of the late submission grade reduction. The instructor will review the student’s rationale for the request and make a determination based on the merits of the student’s appeal. Consideration of the student’s total course performance to date will be a contributing factor in the determination. Students should continue to attend class, actively participate, and complete other assignments while the appeal is pending.

Total Points Possible: 125
Preparing the Assignment: Guideline for Prescribing Opioids For Chronic Pain Assignment
The State Specific Guidelines for Prescribing Controlled Substances & Medical Devices assignment is worth 125 points and will be graded on the quality of required components as summarized in the directions and grading criteria/rubric.
Follow the directions and the grading criteria located in the rubric closely. Any questions about this assignment may be posted under the Q & A Forum or emailed to your faculty.
The document provided should be used and your answers provided within the table provided on this documentLinks to an external site..
Sources/links should be obtained directly from the state’s regulatory organization(s).
It is recommended that you keep a copy of this assignment to provide to potential employers or your Board of Nursing to demonstrate your knowledge of your state laws.
Requirements:
Guidelines and recommendations for your state:
In response to the opioid epidemic, individual states have developed and adopted voluntary guidelines or recommendations for the treatment of acute and chronic non-cancer pain. Based on research done on the state where you will practice clinically, include the following:
Provide the name of your practicing state’s organization, group or task force that created guidelines or recommendations for pain management therapies and education.
Briefly describe an overview of its development and include a web address where this information can be found. If your state does not have guidelines, discuss a federal guideline. (Note: you may need to contact your state’s board of nursing, pharmacy, or medicine if you cannot locate it on your own).
Some states have multiple organizations or initiatives (ex: Ohio) in place to combat the opioid epidemic and advocate for safer opioid prescribing. Explore whether your state has other resources, groups or organizations where prescribers can reference best practices for pain management treatment. If applicable, provide a brief overview of the group’s recommendations or initiatives. If your state does not have another state-specific resource, discuss the guidelines published by the American Pain Society OR Centers for Disease Control and Prevention.
Discuss when the use of opioids is appropriate and for what duration should they be prescribed? Provide a reference for your response. (This question is worth 13 points. 5 points for when opioids are appropriate, 5 points for a safe duration of use, and 3 points for a current edition APA formatted reference.)Guideline for Prescribing Opioids For Chronic Pain Assignment
State specific laws on controlled substance prescribing for the nurse practitioner:
Research your state laws on advanced practice nurses’ authority to prescribe controlled substances. Based on research done on the state where you will practice clinically, include the following:
Identify the law, rule, code, or statute that describes the advanced practice nurse’s authority to prescribe controlled substances in your state.
Discuss the provisions of the law, rule, code, or statute with regard to the following:
Conditions or limits on prescribing schedule I-V controlled substances.
Requirements (if any) in documentation for treating acute and chronic pain.
Are there specific requirements for advanced practice nurses to reference the state’s prescription drug monitoring database before prescribing a controlled substance? If so, what are they?
State Prescription Drug Monitoring Program (PDMP):
Research your state’s PDMP* and provide the following information:
Name of the state’s program.
Website for the state PMDP.
Discuss the registration requirements and process.
Discuss the standards and procedures for the access and review of database information.
State specific laws on medical devices prescribing for the nurse practitioner:
Research your state laws on advanced practice nurses’ authority to prescribe medical devices. These are also called Durable Medical Equipment (DME). Based on research done on the state where you will practice clinically, include the following:
Identify the law, rule, code, or statute that describes the advanced practice nurse’s authority to prescribe medical devices or DME in your state.
Discuss the provisions of the law, rule, code, or statute regarding the following:
Conditions or limits on prescribing medical devices or DME.
Requirements (if any) in documentation needed to support order of medical devices or DME. Guideline for Prescribing Opioids For Chronic Pain Assignment

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Complete the following table with information specific to the state where you plan to practice as a nurse practitioner. Please refer to the rubric in the course to identify how much each prompt is worth. Most are worth 5 or 6 points with one question being worth 10 points. The 10 point question is noted in the table.

Sources should be obtained directly from the state’s regulatory organization(s) and must be cited appropriately.
It is recommended that you keep a copy of this paper to provide to potential employers or your Board of Nursing in order to demonstrate your knowledge of your state laws.

Guidelines and recommendations for your state:

In response to the opioid epidemic, individual states have developed and adopted voluntary guidelines or recommendations for the treatment of acute and chronic non-cancer pain. Based on research done on the state where you will practice clinically, include the following:

Provide the name of your practicing state’s organization, group or task force that created guidelines or recommendations for pain management therapies and education.

Organization, group, or task force name

Illinois Department of Public Health (IDPH).

Where you found this information (weblink):

https://dph.illinois.gov/topics-services/opioids.html

Briefly describe an overview of its development and include a web address where this information can be found. If your state does not have guidelines, discuss a federal guideline. (Note: you may need to contact your state’s board of nursing, pharmacy, or medicine if you cannot locate it on your own).

Overview of your state’s guideline development with web address.

The Centers for Disease Control (CDC) Guidelines for Prescribing Opioids are the federal guidelines utilized as best practice for healthcare professionals (including clinicians and physicians) prescribing opioids for chronic and acute pain in the State of Illinois (CDC, 2017). Equally, the Opioid Prescribing Guidelines: For Patients in the Emergency Department and Immediate Care Centers were also developed by the Illinois Health and Hospital Association (IHA) to tackle the worsening opioid epidemic in the State (Hopedupage, n.d).

Locate federal guidelines and provide a link to federal guidelines you could use in practice as a NP

Federal guidelines: The CDC Guidelines for Prescribing Opioids

https://www.cdc.gov/drugoverdose/prescribing/guideline.html

https://www.hopedupage.org/163/Opioid-Prescribing-Guidelines

Some states have multiple organizations or initiatives (ex: Ohio) in place to combat the opioid epidemic and advocate for safer opioid prescribing. Explore whether your state has other resources, groups or organizations where prescribers can reference best practices for pain management treatment. If applicable, provide a brief overview of the group’s recommendations or initiatives. If your state does not have another state-specific resource, discuss the guidelines published by the American Pain Society OR Centers for Disease Control and Prevention.

Provide a brief overview of the group’s recommendations or initiatives (provide link to where you found information).

1. Illinois Health and Hospital Association

The organization supports initiatives aimed at reducing access to powerful painkillers, enhancing response interventions among healthcare providers and encouraging individual recovery.

2. Illinois Department of Healthcare and Family Services

· Conducting drug utilization review.

· Promoting the safe usage of controlled substances.

· Development of educational materials on drug utilization (Illinois Department of Healthcare and Family Services, 2022).

3. The Governor’s Opioid Prevention and Intervention Task Force

· Development and implementation of policy changes related to tackling the opioid crisis.

· Expanding the usage of prescription monitoring program by healthcare providers.

4. Prescribing Practice Committee

· Development of evidence-based recommendations to support the successful implementation of the State of Illinois Opioid Action Plan (Illinois Department of Financial and Professional Regulation, n.d.).

Provide a brief overview of the guidelines published by the American Pain Society OR Centers for Disease Control and Prevention (provide link to where you found information).

The CDC Guideline for Prescribing Opioids for Chronic Pain provides a set of recommendations for primary care practitioners involved in prescribing of opioids for chronic or acute pain of active cancer treatment, end-of-life care and palliative care (

CDC, 2017)Guideline for Prescribing Opioids For Chronic Pain Assignment. This Federal Opioid Prescribing Guideline is essentially aimed at enhancing communication between patients and providers with regards to the benefits and risks of opioid therapy when used in chronic pain management, enhancing the effectiveness and safety of treatment, reducing adverse effects often connected to extended opioid therapy including overdose or opioid use disorder. The CDC also published another federal Opioid prescribing Guidelines for patients in the emergency department and immediate care centers. This particular guideline recommends that opioids should not be deemed to be a first-line therapy for a majority of patients with chronic pain from minor injuries, and hence the need for considering non-pharmacological interventions or drugs as first-line treatment for acute and chronic pain (Illinois Health and Hospital Association, n.d.).

https://www.cdc.gov/mmwr/volumes/65/rr/rr6501e1.htm

https://www.team-iha.org/files/non-gated/quality/opioid-guidelines-longversion.aspx

Discuss when the use of opioids is appropriate and for what duration should they be prescribed? Provide a reference for your response. (This question is worth 10 points. 4 points for when opioids are appropriate, 4 points for a safe duration of use, and 2 points for a current edition APA formatted reference.)Guideline for Prescribing Opioids For Chronic Pain Assignment

Although opioids are widely used in managing or treating chronic pain, they are considered to be the commonly misused type of prescription medications and controlled substances in the United States. Gershman (2017) explained that the prevalence of unsafe prescribing and dispensing practices have played a major role in exacerbating the risk of fatal overdose and opioid use disorder. These findings indicate that the appropriate use of opioids should be informed by a comprehensive analysis of the risks and patients of opioid use to patients prior to commencement of the opioid therapy. When it comes to the safe duration of opioid use, the IDHP (2022) noted that the use of opioids is appropriate when care coordination is attained to enhance consultation, communication and interactions between the provider and patients receiving chronic opioid therapy. Kalso and Iseki (2022) added that a comprehensive reduce of the case management plans and medical records for patients with a pain contract may also ensure the effectiveness and safety of long-term opioid therapy. As a result, appropriate use of high-risk opioids can be attained the proper use of established guidelines, provider education as well as multidisciplinary coordination among a wide range of healthcare professionals with the core intention of attaining excellence in evidence-based patient-centered care.

State specific laws on controlled substance prescribing for the nurse practitioner:

Research your state laws on advanced practice nurses’ authority to prescribe controlled substances. Based on research done on the state where you will practice clinically, include the following:

Identify the law, rule, code, or statute that describes the advanced practice nurse’s authority to prescribe controlled substances in your state.

Link to where you found law, rule, code, or statute for your state.

The Illinois Controlled Substances Act

What does the law, rule, code, or statute say?

Amended in 2018, this piece of legislation prohibits the usage of illegal drugs including methamphetamines, heroin, cocaine, and other controlled drugs and substances without a prescription. It also categorized dangerous substances into ‘schedules’ based on the potential harm of the identified controlled substance or illegal drug (DHS, 2018).

Discuss the provisions of the law, rule, code, or statute regarding the following:

Conditions or limits on prescribing schedule I-V controlled substances.

· Any prescription must be limited to no more than a 30-day supply, with any subsequent continuation authorized only after approval of the collaborating provider (Gershman, 2017).

· All prescriptions for controlled substances must contain the following (date prescription was issues, prescriber’s signature, medication name, patient’s full name and address, strength, dosage form , directions for use, quantity prescribed, prescriber’s name, registration number and address) (Gershman, 2017).

· A prescription for schedule III, IV and V controlled drugs and substances may be transferred only from the original pharmacy and only one time for the purpose of original fill or refill dispending and may not be subject to further transfer (DHS, 2018).

· A written prescription for Schedule III, IV, or V controlled substances shall not be filled or refilled more than 6 months after the date the prescription was issued (Illinois Department of Financial and Professional Regulation, n.d.).

· Prescriptions for a controlled substance in the state of Illinois must be issues for a legitimate medical purpose.

Requirements (if any) in documentation for treating acute and chronic pain. If your state has no requirements for this, confirm with a link of where you found this information.

The provision of 7-day supply of prescribed medications for acute or chronic pain is to be documented in the patient’s medical record by the registered practitioner.

Are there specific requirements for advanced practice nurses to reference the state’s prescription drug monitoring database before prescribing a controlled substance?

Yes

If yes, what are they? If not, how would they be helpful?

All prescribers including advanced practice registered nurses in the State of Illinois with an Illinois controlled substance license must register with the Prescription Monitoring Program and focus on utilizing the program to make assessment of patient access to controlled medications and/or substances.

State Prescription Drug Monitoring Program (PDMP): Research your state’s PDMP* and provide the following information:

Name of the state’s program.

Illinois Prescription Monitoring Program, an electronic database designed for collecting, tracking and storing of reported data for controlled substances in Illinois (Office of the Auditor General, 2021).

Website for the state PMDP.

http://www.ilpmp.org/

Discuss the registration requirements and process.

Each Prescriber in Illinois must register with the PMP (Illinois State Dental Society, 2022). In order to register:

1. the prescriber is expected to visit this website: https://www.ilpmp.org/CDC/login.php

2. click register for an Account

3. Click ILPMP website registration

4. Click Resident/Prescriber

5. Comply with the registration stages.

Discuss the standards and procedures for the access and review of database information.

When using the Illinois PMP, licensed dispensers and prescribers of controlled drugs or substances can access and view the stored data and information for prospective and current patients only. Law enforcement authorities are only legally allowed to secure an indirect access to prescription data or history of a particular patient during an active investigation process (Illinois Prescription Monitoring Program, 2022).

State specific laws on medical devices prescribing for the nurse practitioner:

Research your state laws on advanced practice nurses’ authority to prescribe medical devices. These are also called Durable Medical Equipment (DME). Based on research done on the state where you will practice clinically, include the following: Guideline for Prescribing Opioids For Chronic Pain Assignment

Identify the law, rule, code, or statute that describes the advanced practice nurse’s authority to prescribe medical devices or DME in your state.

Link to where you found law, rule, code, or statute for your state regarding prescribing DME in your state.

Nurse Practice Act

What does the law, rule, code, or statute say regarding prescribing DME in your state?

The certified registered nurse should perform a face-to-face encounter with the patient when prescribing durable medical equipment, and to retain a copy of the certification of the item for audit purposes (Illinois General Assembly, n.d.).

Discuss the provisions of the law, rule, code, or statute regarding the following:

Conditions or limits on prescribing medical devices or DME.

· A number of DME are subject to face-to-face encounter requirements under the Home Health Benefit.

· Nurses of APRNs are authorized to prescribe durable medical devices and medications only upon delegation of authority from the certifying physician (Illinois Department of Healthcare and Family Services, 2017).

Requirements (if any) in documentation needed to support order of medical devices or DME.

The medical equipment providers are required to submit documentation of a face-to-face encounter certification with requests for approval for particular equipment or supplies (Illinois Department of Healthcare and Family Services, 2017).

References

CDC, (2017).CDC Guideline for Prescribing Opioids for Chronic Pain — United States, 2016. https://www.cdc.gov/mmwr/volumes/65/rr/rr6501e1.htm

DHS, (2018).Illinois Opioid Crisis Response Advisory Council: Recommendations for Implementing Action Plan Strategies. https://www.dhs.state.il.us/OneNetLibrary/27896/documents/CommitteeRecommendationsGoalandMetricsJanuary122018.pdf

Gershman, J. (2017).4 Controlled Substance Laws and Regulations You Should Know. https://www.pharmacytimes.com/view/4-controlled-substance-laws-and-regulations-you-should-know-

Hopedupage, (n.d.).Opioid Prescribing Guidelines. https://www.hopedupage.org/163/Opioid-Prescribing-Guidelines

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IDHP, (2022).Prevention & Harm Reduction. https://dph.illinois.gov/topics-services/opioids/prevention.html

Illinois Department of Financial and Professional Regulationm (n.d.). FAQs for Community Pharmacies. https://idfpr.illinois.gov/FAQ/DPR/Pharmacy%20FAQ.pdf

Illinois Department of Healthcare and Family Services, (2017).Provider Notice Issued 07/07/2017. https://www2.illinois.gov/hfs/MedicalProviders/notices/Pages/prn170707a.aspx

Illinois Department of Healthcare and Family Services, (2022). Drug Utilization Review. https://www2.illinois.gov/hfs/MedicalProviders/Pharmacy/Pages/DrugUtilizationReview.aspx

Illinois General Assembly, (n,d,).225 ILCS 65/ Nurse Practice Act. https://www.ilga.gov/legislation/ilcs/ilcs5.asp?ActID=1312&ChapterID=24

Illinois Health and Hospital Association, (n.d.).Opioid Prescribing Guidelines For patients in the Emergency department and Immediate care centers. https://www.team-iha.org/files/non-gated/quality/opioid-guidelines-longversion.aspx

Illinois Prescription Monitoring Program, (2022).Prescription Monitoring Program: Frequently Asked Questions. https://www.ilpmp.org/QandA.php

Illinois State Dental Society, (2022).Controlled Substance License Holders: It is required to register with the PMP! https://www.isds.org/news-details/2022/06/16/pmp

Kalso, E., & Iseki, M. (2022). Chronic pain and opioids —how to control proper prescribing? Pain Research, 37(1), 1-6.

https://doi.org/10.11154/pain.37.1

Office of the Auditor General, (2021).Performance Audit of the Illinois Prescription Monitoring Program. https://www.auditor.illinois.gov/Audit-Reports/Performance-Special-Multi/Performance-Audits/2021_Releases/21-Prescription-Monitoring-Pgm-Perf-Full.pdf Guideline for Prescribing Opioids For Chronic Pain Assignment