Narcotic overdoseThe Massachusetts Department of Public Health emphatically tightened regulations on prescribing and refilling controlled drugs this year, largely in response to the persistent and increasing epidemic of deaths in our state from heroin overdoses. That addiction scourge alone now accounts for about three deaths every day. I find that astounding, and discouraging.

How You May Be Affected

The new regulations are designed to tighten up the prescription process for narcotics in order to reduce the leakage from prescribed controlled drugs for pain (such as Percocet and Vicodin) into the street traffic circulation. While it is not clear that purloined or inappropriate prescriptions are the major or even a major source of illicit narcotics, we nevertheless have to follow the new procedures. We no longer can phone in narcotics prescriptions with a hard copy to follow. And narcotics prescriptions are no longer refillable even for those drugs such as Vicodin for which this was previously allowed.

Hard Copy Only for New Narcotic Rx

To initiate a new prescription for a narcotic, the patient will need to take a signed prescription written or printed on special safety paper to the pharmacy to have it filled. No exceptions. This will make for some interesting situations over weekends if serious short-term pain relief is required.

No Refills for Narcotic Rx

No refills means we will need to be very careful about the narcotic prescription to try to be clear it will not run out on a weekend, for example, if an extension is likely to be needed, and more office visits will be needed to validate that need and provide the prescription. For anyone on chronic pain meds, we will need adequate lead time (about a week) to produce a renewal Rx and mail it to you, where such practice would be safe and appropriate.

PMP (Prescription Monitoring Program)

I now participate, along with all other Massachusetts physicians, in the prescription monitoring program (PMP), which is an online database of all controlled-drug prescriptions in the Commonwealth. We are supposed to check that database before prescribing narcotics for any new patient and at various other times for existing patients. The PMP was, of course, off to a bit of a rocky start but will likely end up being reasonable to use. And it will make it easy to determine if a patient is getting narcotics or other controlled drugs from multiple providers without knowledge or coordination.

The Upshot

Narcotics are now more difficult to prescribe or to refill, because hard copy original signature prescriptions are required and refills are not allowed. In addition, there is electronic monitoring of all narcotics prescriptions by a Department of Public Health program (PMP) with participation by all prescribers. I hope and believe we will adjust and this tightening will help stem the current horrible epidemic of drug abuse. I’ll update you and expand on this issue later this year.

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