Virginia Prescription Monitoring Program Overview

The Virginia Prescription Monitoring Program (PMP) aims to track and analyze prescription drug usage to combat substance abuse. Through a comprehensive database, the program helps healthcare providers, law enforcement, and patients access vital information to prevent misuse and overdose deaths. The program's initiatives include monitoring illicit drug initiates, fatal prescription drug overdoses, and accessible reporting for prescribers and pharmacists.

• Prescription Monitoring Program
• Drug Abuse Prevention
• Substance Misuse Monitoring
• Virginia Healthcare
• Prescription Drug Database

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1. VIRGINIA PRESCRIPTION MONITORING PROGRAM C.A.R.E Presentation February 27, 2015 Ralph Orr Director, Virginia Prescription Monitoring Program

2. Past Year Initiates of Specific Illicit Drugs among Persons Aged 12 or Older: 2013 3000 Numbers in Thousands 2427 2500 2000 1539 1500 1180 1000 751 603 601 563 482 500 169 128 32 0 Marijuana Pain Tranquilizers Ecstasy Stimulants Cocaine Inhalants LSD Heroin Sedatives PCP Relievers Source: SAMHSA, NSDUH, 2013

4. Number of Fatal Prescription Drug Overdose Compared to All Drug/Poison Deaths by Year, 2007-2013 1000 912 All Drug/Poison Deaths Prescription Drug Deaths 900 819 800 800 735 721 713 690 700 Number of Deaths 636 634 572 562 561 600 510 495 500 400 300 200 100 0 2007 2008 2009 2010 Year 2011 2012 2013 Source: Virginia Office of the Chief Medical Examiner 2104 1 One or more drugs/poisons from different drug categories may have caused or contributed to death

5. www.dhp.virginia.gov

6. Prescription Monitoring Program 24/7 Database of Schedule II IV Prescriptions Pharmacies, dispensing physicians report within 7 days Reporting exemptions include: samples; emergencies; administration of covered substances; dispensing to patients in nursing homes, hospitals, hospice; veterinarians; narcotic maintenance treatment program PMP is interoperable with 17 states, including WV, KY & TN

7. Who May Get PMP Information? Prescribers and Pharmacists for their patients Investigators for licensing boards, if there is an open investigation Certain law enforcement agents, if there is an open investigation Patients for their own prescription history PMP may provide unsolicited reports on recipients to their prescribers or law enforcement, if criteria for potential misuse are met PMP may not provide unsolicited reports on prescribers to DHP investigators or law enforcement

8. Department of Health Professions Phone:(804)367-4566 Email:pmp@dhp.virginia.gov Fax:(804)527-4470 Patient RX History Report Date: 09-17-2012 Page: 1 of 1 Search Criteria: First Name = pXXXXXX And Last Name = wXXXXXX And D.O.B. = xx/xx/1977 And Request Period '08/17/2011' To '09/17/2012' Patients that match search criteria Pt ID Name DOB Address 8854 WXXXXXX, PXXXXXXX xx/xx/1977 246511506 2641 9538 WXXXXXX, PXXXXXXX WXXXXXX, PXXXXXXX xx/xx/1977 xx/xx/1977 24651 246510000 8177 6566 WXXXXXX, PXXXXXXX WXXXXXX, PXXXXXXX xx/xx/1977 xx/xx/1977 246309317 246309369 3201 0904 WXXXXXX, PXXXXXXX WXXXXXX, PXXXXXXX xx/xx/1977 xx/xx/1977 24651 24630 DAYS SUPPLY 1535 6449 WXXXXXX, PXXXXXXX WXXXXXX, PXXXXXXX xx/xx/1977 xx/xx/1977 24651 24630 9021 0546 WXXXXXX, PXXXXXXX WXXXXXX, PXXXXXXX xx/xx/1977 xx/xx/1977 246309317 246511506 7227 7862 WXXXXXX, PXXXXXXX WXXXXXX, PXXXXXXX xx/xx/1977 xx/xx/1977 24651 24651 Prescriptions Fill Date Product, Str, Form Quantity Days Pt ID Prescriber Written Rx # N/R Pharm Pay 09/11/2012 OXYCODONE HYDROCHLORIDE, 5 MG, TABLET 180.00 30 8177 30 8177 30 8854 7 8177 30 546 30 8177 30 8854 30 8854 5 8177 30 8177 30 8854 30 6566 30 6566 14 6566 30 8854 7 8854 30 546 30 9021 30 9021 30 9021 30 546 30 8177 30 8177 30 8177 30 546 30 8177 30 8177 30 8177 53 09/11/2012 02009062 02009063 04474070 04419624 04104201 04018997 00722052 00722053 04419371 04018997 837796 0926544 0926545 0926546 837796 836139 04103006 02008205 02008206 04017819 04103006 02007971 02007972 04017301 04102362 02007747 02007748 04016781 N 92 92 04 04 09/11/2012 OXYCODONE HYDROCHLORIDE, 15 MG, TABLET 180.00 53 09/11/2012 N 09/06/2012 ZOLPIDEM TARTRATE, 5 MG, TABLET, FILM COATED 30.00 36 09/06/2012 N 5 4 04 08/28/2012 CLONAZEPAM, .5 MG, TABLET 21.00 12 08/27/2012 N 08/24/2012 ALPRAZOLAM, 1 MG, TABLET 120.00 27 08/24/2012 N 15 92 08/21/2012 ALPRAZOLAM, 1 MG, TABLET 120.00 27 07/24/2012 R 08/11/2012 OXYCODONE HYDROCHLORIDE, 30 MG, TABLET 120.00 53 08/11/2012 N 12 12 08/11/2012 OXYCODONE HYDROCHLORIDE, 5 MG, TABLET 120.00 53 08/11/2012 N 08/04/2012 ALPRAZOLAM, .5 MG, TABLET 30.00 89 08/04/2012 N 4 92 Pay: 01 = Private Pay 02 = Medicaid 03 = Medicare 04 = Commercial Ins. 05 = Military Inst. and VA 06 = Workers Comp 07 = Indian Nations 99 = Other 07/25/2012 ALPRAZOLAM, 1 MG, TABLET 120.00 27 07/24/2012 N 07/17/2012 ALPRAZOLAM, 1 MG, TABLET 120.00 27 06/21/2012 R 95 56 01 04 07/15/2012 OXYCODONE HYDROCHLORIDE, 30 MG, TABLET 120.00 22 07/14/2012 N 07/15/2012 OXYCODONE HYDROCHLORIDE, 5 MG, TABLET 120.00 22 07/14/2012 N 56 56 04 04 07/15/2012 ALPRAZOLAM, 1 MG, TABLET 32.00 22 07/14/2012 N 06/21/2012 ALPRAZOLAM, 1 MG, TABLET 120.00 27 06/21/2012 N 95 95 01 01 06/05/2012 ALPRAZOLAM, 1 MG, TABLET 30.00 89 06/05/2012 N 05/23/2012 ALPRAZOLAM, 1 MG, TABLET 120.00 27 04/25/2012 R 15 92 05/15/2012 OXYCODONE HYDROCHLORIDE, 30 MG, TABLET 120.00 53 05/15/2012 N 05/15/2012 OXYCODONE HYDROCHLORIDE, 5 MG, TABLET 120.00 53 05/15/2012 N 92 92 05/15/2012 ALPRAZOLAM, 1 MG, TABLET 120.00 53 05/15/2012 N 04/25/2012 ALPRAZOLAM, 1 MG, TABLET 120.00 27 04/25/2012 N 15 92 04/16/2012 OXYCODONE HYDROCHLORIDE, 5 MG, TABLET 120.00 53 04/16/2012 N 04/16/2012 OXYCODONE HYDROCHLORIDE, 15 MG, TABLET 120.00 53 04/16/2012 N 92 92 04/16/2012 ALPRAZOLAM, 1 MG, TABLET 120.00 53 04/16/2012 N 03/26/2012 ALPRAZOLAM, 1 MG, TABLET 120.00 27 02/28/2012 R 15 92 03/16/2012 OXYCODONE HYDROCHLORIDE, 15 MG, TABLET 150.00 53 03/16/2012 N 03/16/2012 OXYCODONE HYDROCHLORIDE, 5 MG, TABLET 210.00 53 03/16/2012 N 92 92 03/16/2012 ALPRAZOLAM, 1 MG, TABLET 120.00 53 03/16/2012 N N/R: N=New R=Refill Pay:01=Private Pay 02=Medicaid 03=Medicare 04=Commercial Ins. 05=Military Inst. and VA 06=Workers Comp 07=Indian Nations 99=Other Prescribers for prescriptions listed Total Prescriptions: 70 12 WV 24740 36 WV 26554 53 WV 25801 27 VA 24641 22 WV 24870 89 VA 24651 Pharmacies that dispensed prescriptions listed 15 VA 24651 , PHONExxxxxxxx71 4 VA 24630 , PHONExxxxxxxx00 56 VA 24134 92 VA 24630 , PHONExxxxxxxx37 95 24651 , PHONExxxxxxxx77 12 VA 24073 , PHONExxxxxxxx37 www.dhp.virginia.gov 5 VA 24637 , PHONExxxxxxxx38 92 VA 24630 , PHONExxxxxxx14

9. Registered Users of PMP DataCenter 1/1/13 - 12/31/14 25000 23742 22373 20557 19734 18841 20000 16702 16628 15670 14654 14453 13955 15000 13335 12044 Total Users 11006 Prescribers 10000 Pharmacists 5544 5311 4926 4690 4513 3869 5000 2954 0 0 0 0

10. Annual Totals 2010 - 2014 1870196 2000000 1800000 1600000 1313861 1400000 1200000 859765 1000000 Total Requests 800000 602294 433450 600000 400000 200000 0 2010 2011 2012 2013 2014 Source: Virginia PMP

11. Percent of Queries Made by Prescriber Group 4th Qtr 2014 800000 Prescriptions Written by Prescriber Group 700000 600000 PMP Queries Made by Prescriber Group 500000 400000 300000 % of Total Queries by Prescriber Group 1-24 = 4.96% 25-59 = 5.96% 50-99 = 5.84% 100-249 = 6.61%% 250-499 = 6.2% 500-999 = 7.49% 1000+ = 11.16% 200000 74459 100000 55382 42444 42155 14649 7227 4899 0

12. Governors Task Force on Prescription Drug and Heroin Abuse Five Workgroups Initial Recommendations Next meeting March19, 2015 See link to Task Force information at www.dhp.virginia.gov

13. MANDATORY PMP REGISTRATION OF PRESCRIBERS 54.1-2522.1. (Effective July 1, 2015) Registration with the PMP upon filing an application for licensure or renewal of licensure, if the prescriber is not already registered HB1841: Adds Pharmacist and allows for registration not tied to renewal (Eff. 1/1/2016)

14. MANDATORY USE OF PMP BY PRESCRIBERS The prescribing of benzodiazepine or an opiate anticipated to last more than 90 consecutive days and for which a treatment agreement is entered into * Or drugs approved for use in opioid addiction therapy shall, prior to or as a part of execution of a treatment agreement with the patient

15. QUESTIONS?