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Texas Hospitals and the Opioid Epidemic

Every day hospitals and health systems see the effects of the nation’s growing opioid epidemic. Opioids accounted for nearly 70 percent of drug overdose deaths in the U.S. in 2016—five times higher than opioid-related overdose deaths in 1999.

Hospitals are on the front lines in part because of the increased morbidity and mortality related to prescription opioid drug use. Texas Medicaid claims for opioid-related emergency department visits, for example, increased by more than 40 percent from 2008 to 2011.

Prescription Monitoring: An Rx For Reducing Opioid Misuse

All physicians will be required to check the Prescription Monitoring Program before prescribing controlled substances beginning in 2019. Pharmacies are now currently required to report dispensed controlled substances to the PMP. Join THA and the Texas State Board of Pharmacy for a webinar on June 13 to share information about using the PMP and the new legislative mandate during THA’s webinar.

Hospital emergency departments have a responsibility to treat every individual who presents for care. Unfortunately, some patients see this as an opportunity to seek medication for non-therapeutic purposes. Despite prescribing a fraction of the opioid prescriptions written nationally, opioid prescriptions from emergency departments account for approximately 45 percent of opioids diverted for non-medical use.

To limit the number of inappropriate opioid prescriptions and help curb opioid misuse and abuse among individuals who exhibit drug-seeking behavior and to prevent new addictions, the Texas Hospital Association developed recommended, voluntary prescribing guidelines for hospital emergency departments.

Developed collaboratively by THA’s Behavioral Health Council, Quality and Patient Safety Council and Hospital Physician Executive Council, the guidelines were formally endorsed by THA’s Board of Trustees in February 2018.

THA’s guidelines, in conjunction with newly required prescription monitoring at the Texas State Board of Pharmacy, will help to reduce the number of opioid-related addictions and deaths in Texas.

HB 2561 – Sunset Reauthorization for the Texas State Board of Pharmacy

Opioid-Related Provisions:

  • Requires the agency to work with other agencies to identify potentially harmful prescribing practices and patient prescription patterns that suggest drug diversion or drug abuse.
  • Requires dispensing pharmacists to send all prescription information to the Prescription Monitoring Program by the following business day.
  • Beginning in 2019, all prescribers and dispensers shall consult the PMP prior to dispensing or prescribing opioids, benzodiazepines, barbiturates or carisoprodol. *There is an exception for cancer patients.
  • Each regulatory agency that licenses, certifies or registers prescribers must implement guidelines for responsible prescribing of opioids, and access information submitted to TSBP to determine whether the prescriber is engaging in potentially harmful prescribing practices.
  • Creates a joint interim committee to conduct an interim study on the monitoring of the prescribing and dispensing of controlled substances in this state.

SB 315 – Texas Medical Board's Requirement to Adopt Opioid Prescribing Guidelines

Opioid Related Provisions:

  • Permits TMB to inspect uncertified pain management clinics or facilities. TMB must establish grounds for inspection, including grounds based on the population of patients served, the volume or combination of drugs prescribed and other criteria that TMB deems sufficient.
  • TMB must adopt guidelines for the prescription of opioid antagonists. (Note: This provision is also included in SB 584.) The guidelines must address:
    • Prescribing an opioid antagonist to a patient to whom an opioid medication also is prescribed.
    • Identifying patients at risk of an opioid-related drug overdose and prescribing an opioid antagonist to that patient or to a person in a position to administer the opioid antagonist to that patient.