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Prescription Opioid Safety

Drug overdose continues to be the leading cause of adult injury death in the United States. The majority of overdose deaths involve prescription opioid medications. The number of overdose deaths involving opioids have nearly quadrupled since 1999, leading public health officials to declare a nationwide opioid overdose epidemic.


Public Meeting Notice

Advisory Council MeetingOpioid Safety - Public Meeting03/22/2019 @ 1:30 PM - 3:30 PM
Scientific Laboratory
1101 Camino de Salud NE, Albuquerque, NM 87102505-383-9000 Phone - 505-383-9011 Fax

The New Mexico Prescription Drug Misuse and Overdose Prevention and Pain Management Advisory Council meets to receive public comment and consider requests for formal recommendations.

The New Mexico Prescription Drug Misuse and Overdose Prevention and Pain Management Advisory Council meets to receive public comment and consider requests for formal recommendations.

Individuals with Disability

Individuals with a disability who are in need of a reader, amplifier, qualified sign language interpreter, or any other form of auxiliary aid or service to attend or participate in the meeting, please contact Evonne Gantz at least one week prior to the meeting or as soon as possible.

Public Documents

Public documents, including the Prescription Drug Misuse and Overdose Prevention and Pain Management Advisory Council Meeting Agenda and minutes, can be provided in various accessible formats.

This is the Advisory Council 2016 Recommendations of the Governor’s Prescription Drug Misuse and Overdose Prevention and Pain Management Advisory Council and are intended to solidify and expand on work that has been accomplished to date.


What Are Opioids?

Most opioids are narcotic medications used to treat pain. Opioid medications work by binding to specific opioid receptors in the brain, spinal cord, and gastrointestinal tract. In doing so, they minimize the body’s perception of pain. Opioids can also have an effect on parts of the brain and body that regulate mood, blood pressure, and breathing.

Common Opioid Medications

  • Oxycodone (PERCOCET®, OXYCONTIN®, ROXICET®, etc.)
  • Hydrocodone (VICODIN®, NORCO®, LORTAB®, etc.)
  • Hydromorphone (DILAUDID®, EXALGO®, etc.)
  • Codeine (TYLENOL #3, Cough syrups, etc.)
  • Morphine (MS CONTIN®, KADIAN®, AVINZA®, etc.)
  • Oxymorphone (OPANA®, OPANA® ER)
  • Fentanyl (DURAGESIC®)
  • Methadone (METHADOSE®)
  • Buprenorphine (SUBOXONE®, BUTRANS®, SUBUTEX®, ZUBSOLV®, etc.)

Common Side Effects from Opioids

  • Tolerance - needing more medication to get pain relief
  • Physical dependence - withdrawal symptoms when the medication is stopped
  • Increased sensitivity to pain
  • Depression
  • Constipation
  • Dry mouth
  • Sleepiness
  • Itching and poor wound healing
  • Hormone imbalances

Not all opioids are prescription pain relievers. Heroin is also an opioid drug made from morphine and has the same effect on the brain and body as opioid medications used to treat pain. Heroin use is associated with many health risks, including overdose and death. It is usually inhaled or injected and rapidly enters the brain. Once in the brain, heroin is converted back into morphine.


What Is an Opioid Overdose?

Opioids, like all medications, can have adverse reactions. Opioids can cause harmful and severe reactions that slow or even stop breathing. This can happen when a person takes too much of the opioid medication or when a person mixes an opioid with another substance, like alcohol or other sedatives. Because opioids slow or even stop breathing, opioid overdoses can be fatal.


Opioid Overdose Death Is Preventable

Factors that Increase Risk for Overdose:

  • Previous non-fatal overdose.
  • Mixing opioids with other medications like benzodiazepines (Xanax®, Klonopin®, Valium®, etc.) or mixing opioids with alcohol.
  • Opioid doses greater than 90 mg of morphine per day or 60 mg of oxycodone per day.
  • Obtaining overlapping prescriptions from multiple providers and pharmacies.
  • History of mental illness or history of substance use disorder.
  • When opioids are discontinued and then restarted after a period of abstinence. For example, individuals who have been incarcerated or individuals returning home from substance abuse treatment are at especially high risk for overdose if opioids are restarted.
  • Living in rural areas and having low income.

How to Prevent Overdose:

  • Talk to your health care provider and pharmacist about all prescription and non-prescription medications.
  • Do not mix opioids with alcohol, benzodiazepines, or other drugs.
  • Do not take opioids more often or in higher quantities than prescribed.
  • Talk to your health care provider or pharmacist about naloxone.

What is Naloxone?

  • Naloxone is a safe medication that reverses and blocks the effects of opioids and can be used by anyone to treat a known or suspected opioid overdose.
  • Naloxone is easy to use and available in many pharmacies in New Mexico. Ask your pharmacist how to obtain and use naloxone.
  • Naloxone only reverses the effects of opioids. It will not have an effect on an overdose caused by another substance (e.g. alcohol, benzodiazepines, stimulants, etc.).
  • Naloxone is usually not self-administered. Tell others about the possible need to use naloxone, how to use it, and where it’s kept in case of overdose. Ask your pharmacist how to obtain and use naloxone.

Are There Any Adverse Effects From Naloxone?

  • Naloxone may cause opioid withdrawal symptoms such as: nausea/vomiting, diarrhea, chills, sweating, anxiety, and combative/disorientation. People who take opioids chronically are more likely to experience these effects.
  • Opioid overdose complications, such as brain damage or death from lack of oxygen, are more alarming than potential side effects from naloxone administration.
  • If naloxone is given to a person who has not taken opioids, it will not have any effect on that person.

Overdose Prevention and Pain Management 2019 Legislation Recommendations

New Mexico’s Overdose Prevention and Pain Management Advisory Council is charged with reviewing the current status of overdose prevention and pain management standards and education efforts for both consumers and professionals. It is also charged with recommending pain management and clinical guidelines. The Council was created pursuant to a revision to the Pain Relief Act in 2012 and is administratively attached to the Department of Health. The Council’s name and membership were modified in 2018 pursuant to Section 24-2D-5.2 NMSA 1978.

New Mexico’s drug overdose death rate has been significantly higher than the national rate for many years. NM experienced a downturn in the drug overdose death rate and an improvement in its national ranking for overdose death from 2014 through 2017. New Mexico’s drug overdose deaths decreased approximately 9% from 2014 to 2017 (decreased from 540 to 491), and the death rate declined from 26.8/100,000 to 24.6/100,000. NM’s ranking among the states improved from 49th in 2014 to 34th in 2017. However, the drug overdose death rate increased in 2018 to 25.5/100,000. New Mexico’s rate remains 17% higher than the national drug overdose rate, which was 21.7/100,000 population in 2017.

Several factors contributed to the improvement from 2014 through 2017. According to the National Safety Council’s 2018 report, New Mexico was one of two states that met all six of their key actions for ending the opioid crisis. These six key actions are: “mandating prescriber education, implementing opioid prescribing guidelines, integrating prescription drug monitoring programs into clinical settings, improving data collection and sharing, treating opioid overdose, and increasing availability of opioid use disorder treatment”. Improved prescribing practices and increased availability of naloxone has led to a 15.7% decrease in the prescription drug-related death rate, from 11.11/100,000 in 2012 to 9.37/100,000 in 2018. New Mexico continues to show improvements in these areas thanks to the coordinated efforts of many stakeholders (such as state agencies, public and private organizations, and universities) and with the support of the legislature and the Governor.

Several factors contributed to the improvement from 2014 through 2017. According to the National Safety Council’s 2018 report, New Mexico was one of two states that met all six of their key actions for ending the opioid crisis. These six key actions are: “mandating prescriber education, implementing opioid prescribing guidelines, integrating prescription drug monitoring programs into clinical settings, improving data collection and sharing, treating opioid overdose, and increasing availability of opioid use disorder treatment”. Improved prescribing practices and increased availability of naloxone has led to a 15.7% decrease in the prescription drug-related death rate, from 11.11/100,000 in 2012 to 9.37/100,000 in 2018. New Mexico continues to show improvements in these areas thanks to the coordinated efforts of many stakeholders (such as state agencies, public and private organizations, and universities) and with the support of the legislature and the Governor.

Continued improvements in naloxone training and distribution are necessary to decrease the death rates due to both licit and illicit opioids. Further research in effective treatments for methamphetamine use disorder are urgently needed.

Recommendations

The following 2019 recommendations provided by this Advisory Council are intended to solidify and expand on work that has been accomplished to date.

  • New Mexico law (Chapter 94, Laws of 2019) should be amended by exempting health care providers while they are treating a patient who is in a nursing home or in hospice care.
  • Chapter 59, Laws of 2017, which resulted from SB 370, should be amended to eliminate the contingency of “agency funding and agency supplies of naloxone” from the requirement that naloxone be made available to individuals upon release from criminal justice settings, to patients during and after their participation in opioid treatment programs and should be distributed by law enforcement offices to individuals who have experienced overdose or are at risk for opioid overdose.
  • The Department of Health should ask the Governor to ask the NM Congressional Delegation to support the “No Pain Act”, which will expand Medicaid coverage to opioid alternatives, which could include injectable nerve blocks, physical therapy and chiropractic care.
  • The Legislature should permit the establishment of, and fund a Safe Injection Site Pilot Program.
  • New Mexico health insurers should eliminate prior authorization and other barriers for all forms of MAT related to treatment of substance use disorder.
  • The Department of Health should purchase and distribute fentanyl test strips through the Hepatitis and Harm Reduction Program. Fentanyl test strips have been found to be effective in detecting fentanyl and other drugs.
  • The Department of Health should incentivize providers to deliver Medication-Assisted Treatment by covering costs associated with fees and efforts to apply, register and prepare for the examination to become board certified in Addiction Medicine.
  • The Legislature should expand the New Mexico Rural Health Care Tax Credit to include physical therapists and physical therapy assistants. Physical therapy is recognized as an alternative treatment for chronic pain.
  • The Legislature should expand the New Mexico Health Services Corps Program to include physical therapists and physical therapy assistants.
  • NM should pilot and evaluate a project of including integrated medicine in Centennial Care and Fee-for-Service Medicaid for a year in Federally Qualified Health Care centers.
  • The Legislature should provide for Copay/Cost Sharing Limits for Doctors of Podiatry, Doctors of Oriental Medicine, and Doctors of Chiropractic in addition to those that currently exist for physical and occupational therapists for physical rehabilitation services.

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How to Administer Intranasal Naloxone

This video provides information on overdose recognition, overdose response, and naloxone administration. Watch the How to Administer Intranasal Naloxone video for more details.