| Date: | 04/21/2023 |
|---|---|
| Referenced Sources: |
2018 Chapter 208 M.G.L. 94C, § 24A |
To: Massachusetts Licensed Prescribers
From: James Lavery, Director, Bureau of Health Professions Licensure
David Johnson, Director, Prescription Monitoring Program
Date: April 21, 2023
Subject: PMP Utilization for Benzodiazepines
Purpose
The purpose of this notice is to inform prescribers of a change in state law for utilizing MassPAT prior to prescribing benzodiazepines.
NOTE: This notice, originally posted in 2018, was updated to include new details regarding exceptions to the requirement to utilize the prescription monitoring program prior to prescribing a Schedule IV or V controlled substance.
Background
Current Department of Public Health (DPH) regulations indicate MassPAT participants must utilize the prescription monitoring program (PMP) prior to issuing a benzodiazepine prescription to a patient for the first time.
On August 9, 2018, Governor Baker signed into law chapter 208 of the acts of 2018, An Act for Prevention and Access to Appropriate Care and Treatment of Addiction. The law’s provisions are designed to aid us all in our collective efforts to prevent prescription medication misuse and overdose, including opioids and benzodiazepines, and to provide critical access to addiction care and treatment.[1] To assist in accomplishing these goals, the law includes updates to M.G.L. 94C, § 24A that direct the Department of Public Health (DPH) to promulgate regulations that require MassPAT participants to utilize the prescription monitoring program (PMP) each time a prescription for a benzodiazepine is issued.
Compliance with Section 24A of Chapter 94C of the General Laws
The Department expects prescribers to check the PMP prior to the issuance of a benzodiazepine prescription, every time, as each check is an opportunity for clinicians and patients to examine medication use and engage in meaningful discussions and education around the safe use of prescription medications and the risks of substance use disorder and overdose, especially for patients who are co-prescribed opioids and benzodiazepines. Clinicians may also consider prescribing naloxone and teaching patients and/or family members how to use it.
105 CMR 700 also requires practitioners to utilize the PMP prior to prescribing a Schedule IV or V controlled substance, as designated in guidance issued by the Department pursuant to Chapter 94C of the General Laws. Currently, benzodiazepines are the only Schedule IV or V substances so designated.
This utilization requirement does not apply in the following instances:
- providing care to hospice patients;
- emergency care is required and, in the professional opinion of the prescriber, utilization of MassPAT is likely to result in patient harm;
- it is not reasonably possible to utilize MassPAT, e.g., the system is not operational due to temporary technological or electrical failure;
- practitioner is granted a waiver pursuant to 105 CMR 700.012(H); and
- other exceptions as defined in guidance issued by the Department.
For more resources on overdose prevention strategies for clinicians, visit https://www.mass.gov/service-details/information-for-treatment-providers.
We look forward to bringing you updates on developing regulations to address this requirement.
Contact Information
Questions or concerns regarding this information should be directed to the Prescription Monitoring Program: mapmp.dph@mass.gov
[1] Benzodiazepine use increases the risk of overdose for individuals using opioids by further contributing to respiratory depression.