President’s Commission Releases Final Report on Opioid Crisis

The President’s Commission on Combating Drug Addiction and the Opioid Crisis released its final report this week.  The report contains 56 recommendations including an expanded drug court system, educational requirements for prescribers, and a media campaign to publicize preventative services.  The following Commission recommendations, among others, may be of particular interest to pharmacy stakeholders:

  1. “The Commission recommends that HHS, DOJ/DEA, ONDCP, and pharmacy associations train pharmacists on best practices to evaluate legitimacy of opioid prescriptions, and not penalize pharmacists for denying inappropriate prescriptions.
  2. The Commission recommends the Administration’s support of the Prescription Drug Monitoring (PDMP) Act to mandate states that receive grant funds to comply with PDMP 54 requirements, including data sharing. This Act directs DOJ to fund the establishment and maintenance of a data-sharing hub.
  3. The Commission recommends federal agencies mandate PDMP checks, and consider amending requirements under the Emergency Medical Treatment and Labor Act (EMTALA), which requires hospitals to screen and stabilize patients in an emergency department, regardless of insurance status or ability to pay.
  4. The Commission recommends that PDMP data integration with electronic health records, overdose episodes, and SUD-related decision support tools for providers is necessary to increase effectiveness.
  5. The Commission recommends ONDCP and DEA increase electronic prescribing to prevent diversion and forgery. The DEA should revise regulations regarding electronic prescribing for controlled substances.
  6. The Commission recommends that the Federal Government work with states to remove legal barriers and ensure PDMPs incorporate available overdose/naloxone deployment data, including the Department of Transportation’s (DOT) Emergency Medical Technician (EMT) overdose database. It is necessary to have overdose data/naloxone deployment data in the PDMP to allow users of the PDMP to assist patients.”

And related to Recommend #11 above, the report recognized the challenge pharmacists face in this epidemic, stating that “[p]harmacists are under pressure to continue filling prescriptions from irresponsible providers. A recent study of Wisconsin pharmacists found that a not insignificant minority did not understand what is legitimate practice under federal and state laws about evaluating the legitimacy of a controlled substance prescription – also known as corresponding responsibility. Further, 36% of these pharmacists considered extended prescribing of opioids to be a violation of law or unacceptable medical practice. In the current crisis, it is critical that all pharmacists and pharmacy programs have the training necessary to responsibly dispense these medications while also not dispensing these powerful medications when the prescription is not legitimate or if it will harm the patient.”183

President Trump declared the opioid crisis a public health emergency last month, and the commission has been working on their recommendations since March.

Read the Final Report

NASPA Shoutout: Check out page 77 of the report to see NASPA’s Naloxone Access in Community Pharmacies map.

Citation 183: Gilson, AM. (2009). Pharmacists and controlled substances prescriptions, Medscape, Accessed here.