Prescriber's Guidelines for Use of the Prescription Drug Monitoring Program

The North Dakota Board of Medicine has issued the following guidelines for use of the Prescription Drug Monitoring Program (PDMP) by prescribers of any controlled substance and gabapentin.  The PDMP is operated by the North Dakota State Board of Pharmacy and accessible at its website, www.nodakpharmacy.com.

The Board will consider the use or non-use of the PDMP in accordance with its guidelines as evidence of whether a practitioner has met the requirements of the North Dakota Medical Practice Act, 43-17-31, N.D.C.C.

Guidelines for use of the Prescription Drug Monitoring Program (PDMP)

These guidelines address the use of the Prescription Drug Monitoring Program by physicians prescribing those drugs reported by the program, which include any controlled substance and gabapentin.

If a physician prescribing any drug reported by the Prescription Drug Monitoring Program has reason to believe that a patient may be abusing or diverting prescribed medications, the physician shall access the Prescription Drug Monitoring Program and document the assessment of the monitoring results to help determine the proper treatment of the patient.

A. When the physician has knowledge that the patient exhibits any of the following signs of potential abuse or diversion, the physician shall request a report from the Prescription Drug Monitoring Program:

1. Selling prescription drugs;
2. Forging or altering a prescription;
3. Stealing or borrowing reported drugs;
4. Taking more than the prescribed dosage of any reported drug;
5. Having a drug screen that is inconsistent with the prescribed drugs by indicating that the patient is not taking the prescribed drugs, is taking additional or illicit drugs or refusing to take a drug screen;
6. Being arrested, convicted or diverted by the criminal justice system for a drug related offense;
7. Violating any prescribing agreement with the physician;
8. Receiving reported drugs from prescribers not disclosed to the treating physician;
9. Having a family member, law enforcement officer or health care professional express concern about the patient’s use of reported drugs.

B. When the patient exhibits any of the following signs of potential abuse or diversion, the physician should consider requesting a PDMP report:

1. Frequently requests early refills of a reported drug for any reason;
2. Appears impaired or excessively sedated to the physician in any patient encounter;
3. Requests reported drugs by street name, color or markings;
4. Has a history of drug abuse or dependency.

C. When a physician expects to prescribe reported drugs to a patient for a chronic condition or for a protracted basis, the physician shall request a PDMP report:

1. Upon determining that such prescribing will be on a protracted basis;
2. At least semi-annually thereafter.

D. A physician shall document the receipt and assessment of PDMP reports made under these guidelines and include them in the patient’s medical record.

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