IHS National Prescription Drug Abuse Workgroup

Transcription

1 IHS National Prescription Drug Abuse Workgroup A Report to the National Combined Councils June 25, 2014

2 IHS PDA Workgroup - History Director was approached in Jan 2012 at NCC by NCCMO regarding PDA epidemic Director commissioned workgroup summer of 2012 Meeting held in Rockville July 2012 workplan produced Meeting in April 2013 workplan updated Workgroup charged with carrying out workplan in fall of 2013

3 IHS PDA Workgroup - Activity Fall subgroups formed Monthly calls held with subgroup leads to monitor progress Chronic Non-Cancer Pain Management Policy and Website for Pain Management have been major outputs

4 Key Recommendations 1) Create national PDA Taskforce 2) Hire national PDA Coordinator 3) Initiate national PDA Campaign 4) Release Chronic Pain Policy 5) Deploy IHS Pain Management website 6) Develop and release PDMP Circular 7) Develop provider training 8) Implement peer review as national standard

5 Key Recommendations 1) Create national PDA Taskforce 2) Hire national PDA Coordinator 3) Initiate national PDA Campaign 4) Release Chronic Pain Policy 5) Deploy IHS Pain Management website 6) Develop and release PDMP Circular 7) Develop provider training 8) Implement peer review as national standard

6 Patient Care Subgroup Co-Chairs: CAPT Stephen Miles Rudd, MD, CMO/Deputy Director, Portland Area IHS (Portland Area) CDR Ted Hall, PharmD, Clinical Psychiatric Pharmacist/Director of Pharmacy, Ho-Chunk Nation (Bemidji Area)- Co-Lead Members Donna Linke, Psychiatric NP, Fort Thompson, SD (Aberdeen Area) Bernie Long, PT, CEO Ft. Thompson/Lower Brule, SD (Aberdeen Area) LCDR Kailee Fretland, PharmD, Clinical Pharmacist, Red Lake, MN (Bemidji Area) CDR Jennifer Betts, MD, CMO, Sonoma Co. Indian Health Project, Santa Rosa, CA (California Area) Jennie Wei, MD, Gallup Indian Medical Center, Gallup, NM (Navajo Area)

7 Patient Care Subgroup Extensively assisted with IHS Pain Management web site development and launch. researched and defined evidence based, safe non-malignant chronic pain management best practices (incorporated into website) Contributed to final revisions of the IHS Chronic Non-Cancer Pain Management Policy (recently approved). National P&T Committee Pain Management Review May 2014 meeting focused on review of 7 drug classes related to pharmacotherapy for pain management Conducted a survey of Chief Pharmacists related to opioid issues (n=104) Produced Formulary Briefs on each drug class (published on NPTC website: ) Tele-partnerships- Engaged in cross collaboration with the PDA Education subgroup resulting in the IHS Tele-Behavioral Health Center of Excellence Pain and Addiction Consultation ECHO.

8 Policy Subgroup Chronic Non-Cancer Pain Policy Release Reinforce Agency stance on medical marijuana Standardized policy on proxy pick-up Standardized policy on employee drug testing

9 Education Subgroup Essential Training for Providers Educational Portals Discussion Boards/Forums Community education resources/materials

10 Monitoring Subgroup Prescription Drug Monitoring Program Circular Status: authored pending approval EHR standardization Status: best practice document authored to be included in next website iteration Patient Urine Drug Testing Best Practice Guideline Status: completed and hosted on pain management website PDMP Peer Review Status: draft document pending leadership comment Naloxone (Clinical) Status: First Responder: in use in Cherokee, pending in Red Lake and White River. Community poster, protocol, and competencies developed for intranasal product. Co-prescribing: in development Pending items: PDMP outcomes measures Patient photo capture in VistaImaging to assist in patient identification (issues with HIM uptake).

11 Disposal/Storage Subgroup IHS Pain Management website: Safe Storage of Medications at Homes Lock It Up: Medicine Safety In Your Home, a video from the Food and Drug Administration Safeguard My Meds Talk About Prescriptions Patient Disposal of Medications Drug Take-Back Programs Resources for disposal in trash FDA website - list of drugs recommended for flushing

12 Enforcement Subgroup Goals of the Enforcement Best Practice To inform I/T/U Staff regarding the relevant regulatory and operational issues surrounding the security, storage, furnishing, dispensing, documentation, and critical incident management related to the use of Controlled Substances. To inform I/T/U Staff regarding Tribal Wellness/Drug Courts as a model for assisting patients to bypass initial or repeat criminal proceedings related to Substance Abuse offenses and to connect them with resources to assist them to build skills and make positive life changes to help prevent relapse related to Substance Abuse. To serve as a resource for I/T/U sites to create, revise, or optimize an Enforcement program related to the use of Controlled Substances at their facilities and to engage I/T/U facility leadership on Enforcement issues.

13 Enforcement Subgroup Content Areas Physical Security of Medications Risk Management/Critical Incident Response Prescription Pad/Paper Security Documentation of Controlled Substance Use Engaging I/T/U Leadership Developing Linkages/Supporting Tribal Drug Courts

14 Interagency Collaboration Subgroup Purpose: To strengthen the federal agency response to prescription drug misuse and abuse for American Indians and Alaska Natives Coordinates with the Office on National Drug Control Policy Implementation of the National Drug Control Strategy Chapter 3 and monitors 8 process measures Established a new AI/AN Interagency PDA Group Leveraging federal PDA resources Interagency Tribal Consultation Plan on PDA Explore opportunities to implement medication assisted treatment (MAT)/office-based opioid therapy (OBOT)

15 Thank You IHS National Prescription Drug Abuse Workgroup CAPT Harry J Brown, MD harry.brown@ihs.gov