States are increasingly playing a regulatory role when it comes to opioid medications. New Mexico's program emphasizes patient-provider relationship over regulatory "dosage thresholds."
Balancing the community's need to curb opioid abuse and diversion with that of the chronic pain patient often leads to States playing an increasing regulatory role. However, New Mexico decided not to establish a "trigger" dosage threshold because of concern that such a policy would interfere with the patient-provider relationship. Instead, the state requires a mandatory continuing medical education course covering both prescription drug abuse prevention and the treatment of pain. Thus, the program is balanced and does not fixate on one problem at the expense of the other. The program was created by several stakeholders—regulators, practitioners, and the public—to ensure balance. To follow is an outline of the New Mexico program:
- In 2012, New Mexico passed Senate Bill 215, requiring all health care professional licensing boards to mandate continuing medical education (CME) about noncancer pain management for health care providers holding DEA licenses to prescribe opioids.1
- The bill also mandated the development of an advisory council to review the state and federal practices regarding prescription drug misuse, overdose prevention, and pain management practices as well as educational programs aimed at professionals and consumers.
- The New Mexico Medical Board developed a committee composed of its board members and pain specialists, and determined that physicians and physician assistants should complete at least 5 hours of CME on the topics of pain and addiction between November 1, 2012 and June 30, 2014.2
- The CME must cover the following topics:
- Pharmacology and risks of controlled substances
- Awareness of the problems of abuse, addiction, and diversion
- Current state and federal rules and regulations for the prescription of controlled substances
- Management of pain treatment
- Thereafter, 5 CME hours on these topics must be taken as part of the 75 CME hours required for license renewal every 3 years.
- Opioid prescribers are mandated to sign up with the New Mexico Board of Pharmacy prescription monitoring program (PMP) and obtain a patient PMP report for the preceding 12 months when initially prescribing chronic opioid therapy (ie, ≥10 days) and every 6 months thereafter.2,3
- A recent study of a half-day course designed to fulfill the CME requirements showed that participants had significant increases in knowledge, self-efficacy, and attitudes after the course based on comparison of pretest and post-test data.4
- While there was a slight increase in total number of opioid prescriptions filled since 2011 in New Mexico, the total mg of morphine equivalent dose of opioids dispensed declined.3 In particular, the rates of high-dose opioid prescriptions declined, whereas rates of low-dose opioid prescriptions increased.4
Last updated on: September 14, 2015
First published on: March 1, 2015