From the Research
In Nevada, prescribers are not required to check the Prescription Drug Monitoring Program (PDMP) before prescribing opioids in certain situations, including hospice or palliative care, skilled nursing facilities, cancer treatment, inpatient hospital care, or emergency situations, as well as for veterinarians prescribing controlled substances for animals. These exceptions are designed to balance the need to monitor controlled substance prescriptions with the need to ensure patients with legitimate medical needs can access necessary medications without undue barriers. According to the most recent study 1, must-access PDMPs have been associated with unintended consequences, including an increase in heroin death rates, highlighting the need for careful consideration of these exceptions.
Some key exceptions to the PDMP requirement include:
- Patients receiving hospice or palliative care
- Patients in skilled nursing facilities
- Patients being treated for cancer
- Patients receiving opioids during inpatient care at a hospital
- Emergency situations where immediate administration is necessary for the proper treatment of the patient
- Veterinarians prescribing controlled substances for animals
For prescription writing, Nevada law allows for emergency dispensing of Schedule II controlled substances without a written prescription under certain circumstances, including immediate need, oral prescription, and provision of a written prescription within 7 days 2. The study by 3 found that PDMP patient data access provisions were most consistently predictive of high-dispensing and high-dose dispensing counties, suggesting that these provisions may be effective in reducing inappropriate dispensing. However, the study by 1 highlights the potential unintended consequences of must-access PDMPs, including an increase in heroin death rates, emphasizing the need for careful consideration of these exceptions.
Overall, the exceptions to the PDMP requirement in Nevada are designed to ensure that patients with legitimate medical needs can access necessary medications while minimizing the risk of diversion and misuse. By prioritizing patient care and safety, these exceptions can help to reduce morbidity, mortality, and improve quality of life for patients in need of opioid prescriptions.