AZ Law.LEcture. 3.16. Arizona.Controlled Substances Prescription Monitoring Program

Question 1

Purpose of the Controlled Substances Prescription Monitoring Program

Answer 1

Improve the State’s ability to identify controlled substance abusers or misusers
and refer them for treatment
Identify and stop diversion of prescription controlled substance drugs

Primary role of the Arizona State Board of Pharmacy in the CSPMP:
Provide a central repository of all prescriptions dispensed for Schedule II, III, IV
and V controlled substances in Arizona

Question 2

What does Controlled Substances Prescription Monitoring Program include?

Answer 2

Includes a computerized central database tracking system track the prescribing,
dispensing, and consumption of Schedule II, III, and IV AND V controlled substances in
Arizona,
Assists law enforcement in identifying illegal activity related to the prescribing,
dispensing, and consumption of Schedule II, III, and IV AND V controlled substances,
Provides information to patients, medical practitioners, and pharmacists to help avoid the
inappropriate use of Schedule II, III, and IV AND V controlled substances, and
Is designed to minimize inconvenience to patients, prescribing medical practitioners and
pharmacies while effectuating the collection and storage of information.

Question 3

Who is required to be registered

with PDMP

Answer 3

“Medical practitioner” means any person who is licensed and authorized by law to use and
prescribe drugs and devices for the treatment of sick and injured human beings or for the
diagnosis or prevention of sickness in human beings in this state or any state, territory or district
of the United States

Question 4

Who is required to be registered
with PDMP-
What health provider is excluded?

Answer 4

Vets are not included

Question 5

Current registration
requirements
Medical prectra

Answer 5

Each medical practitioner who is (1) issued a license (new and renewal) and (2)
possess an Arizona registration under the federal CSA (DEA REGISTRATION) (or intends to apply for registration MUST HAVE current CSPMP registration issued by: AZSBOP

The AzSBOP will notify each pharmacist of the pharmacist’s responsibility to register
with the state board and be granted access to the PDMP central database tracking
system.
◦ Each licensed pharmacist
◦ Employed by a facility with a DEA registration

Question 6

PDMP registration!

Answer 6

Cannot be transferred or assigned to anyone else

If you’re authorized to access, you may do so only using your identifier and you may not use the
identifier of another person.

Question 7

Mandate of Utilization-

prescriber

Answer 7

medical practitioner, before prescribing an opioid analgesic or benzodiazepine CS listed in schedule II, III or IV for a patient,

must obtain a patient utilization report regarding the patient for the preceding 12 months from the CSPMP central database tracking
system at the beginning of each new course of treatment and at
least quarterly while that RX remains a part of the treatment

Question 8

EXCEPTIONS

Answer 8

1. The patient is receiving hospice care or palliative care for a serious or chronic illness.
2. The patient is receiving care for cancer, a cancer-related illness or condition or dialysis treatment.
3. A medical practitioner will administer the CS.
4. The patient is receiving the CS during the course of inpatient or residential treatment in a hospital,
   nursing care facility, assisted living facility, correctional facility or mental health facility.
5. The medical practitioner is prescribing the CS to the patient for no more than a five-day period for an
   invasive medical or dental procedure or a medical or dental procedure that results in acute pain to the
   patient.
6. The medical practitioner is prescribing the controlled substance to the patient for no more than a five-
   day period for an acute injury or a medical or dental disease process that is diagnosed in an emergency
   department setting and that results in acute pain to the patient.

An acute injury or medical disease process does not include back pain!!

Question 9

Utilization mandate dispensers

Answer 9

Before a pharmacists dispenses or before a pharmacy technician or intern at a remote
dispensing pharmacy dispenses CII dispenser shall obtain patient utilization report for preceding
12 months

Question 10

Items that must be reported when dispensing

Answer 10

Name, address, telephone number, prescription number and DEA registration number of dispenser.
Name address and DOB of the person for whom the prescription is written
Name, address, telephone number and DEA registration number of prescribing medical practitioner
Name, strength, quantity, dosage, and NDC of CS dispensed
Date prescription dispensed
Number of refills, if any, authorized
*The date the prescription was issued;
*The method of payment identified as cash or third party; and
*Whether the prescription is new or a refill.
*The last three are added by regulations others are statues requirements

Question 11

time for reporting

Answer 11

The board shall allow the reporter to transmit the required information by electronic data
transfer if feasible or, if not feasible, on reporting forms as prescribed by the board. The reporter
shall submit the required information once each day.

Dispenser submits the required information electronically (unless granted a waiver)

Question 12

When is reporting not required?

Answer 12

CS is directly administered to patient

CS is dispensed by medical practitioner at a state licensed health care facility if quantity dispensed is limited to an amount adequate to treat the patient for a maximum of 72 hours
◦ with not more than two 72 hour cycles within any 15 day period.
CS sample

Wholesale distribution

Facilities registered with the DEA as NTP/OTP

Question 13

AHCCCS contractors (someone is licenced to provide care for access patients); prescription monitoring; controlled substances; review

Answer 13

A. A contractor shall intervene if a member has ten or more prescriptions for controlled
substances within a three-month period.
B. A contractor shall monitor prescriptions that are filled by members and shall intervene with
both the prescriber and the member when excessive amounts of controlled substances are
used. The contractor shall direct cases involving excessive controlled substance use to the
system medical director for review
17

Question 14

Multi-state queries

Answer 14

Note: DO NOT use Multi-State Query, if you only
need data for Arizona, use
Practitioner/Pharmacist Query.

Question 15

Pharmacists have a standing order for?

Answer 15

Naloxone

for a person who is at risk of experiencing an opioid-related overdose or to a family member or community
member who is in a position to assist that person.

Question 16

Opioid antagonist dispensing
regulations- policies and
procedures

Answer 16

1. Documentation of opioid antagonists dispensed under A.R.S. § 32-1979. The documentation shall:
   ◦ Be maintained LIKE PRESCRIPTION RECORDS
2. patient education shall include:
   a. How to prevent an opioid-related overdose;
   ◦ b. How to recognize an opioid-related overdose;
   ◦ c. How to administer an opioid antagonist safely to an individual experiencing an opioid-related overdose;
   ◦ d. Precautions regarding:
   ◦ i. Potential side effects, and
   ◦ ii. Possible adverse events associated with administration of the opioid antagonist; and
   ◦ e. Importance of seeking emergency medical assistance for the individual experiencing an opioid-related overdose before or after
   administering the opioid antagonist; and

Question 17

Pharmacist education

requirement

Answer 17

1. Complete an opioid prevention and treatment training program that includes the following
   information:
   ◦ a. How to recognize the symptoms of an opioid-related overdose,
   ◦ b. How to respond to a suspected opioid-related overdose,
   ◦ c. How to administer all preparations of an opioid antagonist, and
   ◦ d. The information needed by an individual to whom an opioid antagonist is dispensed,

Question 18

Pharmacists regulations

Answer 18

before dispensing an opioid antagonists, shall complete an opioid prevention and treatment training program and include the following info:

• recognize symptoms of opioid related overdose
• respond to suspected opioid-related overdose
• admin all preparations of an opioid antagonists
• info needed by an individual to whom an opioid antagonist is dispensed

pharmacists who has completed the training

1. many administer an opioid antagonist in overdose patients
2. exempt from civil liabilities

Pharmacist may also dispense an opioid antagonist by invoice to community member is not a wholesale distributor.