New Jersey’s Controlled Dangerous Substances Monitoring Tools

 

The Centers for Disease Control and Prevention called our country’s battle with prescription drug abuse, an epidemic (CDC, 2016). They have reported that from 1999 to 2014, 165,000 people have died from prescription drug overdose. In 2007, prescription drug abuse cost our society $55.7 billion. The epidemic has also deteriorated healthcare provider confidence in prescribing opioids. Providers have become hesitant in prescribing controlled substances yet must balance adequate treatment of a patients’ pain. Unfortunately, they are often misguided by patients who illicitly seek prescription medication. To reduce these risks and to increase practitioners’ comfort with prescribing, many states have implemented policies to deter the abuse and misuse of controlled substances, such as prescription monitoring programs. Additionally, at the provider level, best-practice suggests a controlled substance agreement form should be used when prescribing controlled substances. However, observations in various clinical settings suggest that providers may not be fully implementing these safety policies.

 

The state of New Jersey has taken several steps in providing prescribers with the tools and policies necessary to minimize further drug abuse and misuse including; the New Jersey Prescription Monitoring Program and Project Medicine Drop. The state also mandates that nurse practitioners take a six-hour course on responsible prescribing. Are New Jersey’s Nurse Practitioners fully implementing the controlled substance safety policies? Are they using a controlled substance agreement tool? Would they be willing to adopt a universal controlled substance agreement tool developed specifically for New Jersey nurse practitioners? An initiative has started to examine these questions. The project has two aims; 1) to examine and evaluate nurse practitioners’ use of New Jersey’s monitoring tools; and 2) to develop and offer nurse practitioners with a customized Controlled Dangerous Substance (CDS) Agreement Form containing all of the New Jersey requirements.

 

The Institute of Medicine explains, in the Crossing the Quality Chasm, A New Health System for the 21st Century (2001), that evidence translation is essential in delivery of safe, quality care.  Agreement forms which clearly outline treatment goals, promote treatment adherence and efficacy, and reduce the risk of medication abuse and misuse protect both the patient and the provider. Combined with other safety initiatives, the potential to Turn the Tide on the opioid epidemic becomes a potential reality.