Texas Medical Association
By Joey Berlin
September 12, 2019

The state attorney general has agreed with the Texas Medical Association in an official opinion that keeps certified registered nurse anesthetists (CRNAs) from administering anesthesia without physician delegation. 

In the opinion, Attorney General Ken Paxton addressed three questions from Sherif Zaafran, MD, president of the Texas Medical Board (TMB): 

 Schade Hill ‐ Public Policy Pain Champion Award - Representative JD Sheffield, MD

Dr. J.D. Sheffield was elected to the Texas House of Representatives in 2012 to serve the citizens of Texas House District 59, which includes Comanche, Coryell, Erath, Hamilton, McCulloch, Mills, San Saba, and Somervell Counties. He was re-elected to his 4th term in the 2018 March Primary. 

Dr. Sheffield has been practicing family medicine in and around Gatesville for over 25 years. As the only rural physician in the Texas Legislature, Dr. Sheffield has been honored to serve on the House Public Health Committee for all three terms, and currently serves as Vice-Chairman.

Hassenbusch Continued Learning Case Study Presentations

CALL FOR CASE STUDIES: The Texas Pain Society invites members and others to submit case studies to be considered for presentation at the 11th Annual Scientific Meeting.

 Click here to submit your case study online

Click here to download a paper copy for submission

September 6, 2019 marked another successful year of partnership between Texas Pain Society & Texas Society of Anesthesiologist!

Each year TPS presents a 3 hour parallel session regarding pain medicine during the TSA Annual Conference.

This year we had Drs. Max Eckmann, C.M. Schade and Dhanalakshmi Koyyalagunta, MD representing TPS and an interactive crowd that was very engaged in the current standards and best practices for treating chronic pain patients. 

Attorney General Ken Paxton Issues Statement on Chapter 11

Bankruptcy Filing of Purdue Pharma

Description: 
The Texas Prescription Monitoring Program (PMP) helps health professionals make decisions about prescribing and dispensing and can be used to improve patient health. Four experts will share their knowledge about the Texas PMP, enhancements to the system, and new tools available to help you feel confident about sending someone home with opioids.

Learning Objectives:

• Describe the Texas PMP and what it can do. 
• Discuss how to register for and use the Texas PMP. 
• Examine free tools to aid patient conversations about opioid use, misuse, and safe disposal.

1.5 Continuing Education Credits/Contact Hours Available for the Following (live* event only):

Before the 2019 Texas Legislature passed House Bill 3703, the medical use of cannabidiol (CBD) products in Texas was confusing for physicians and authorized only a narrow group of patients: people with intractable epilepsy.

Thanks in part to the new state law, it’s still confusing and includes a somewhat larger group of patients – all patients with epilepsy as well as those with seizure disorders, multiple sclerosis, spasticity, amyotrophic lateral sclerosis (ALS), autism, terminal cancer, and incurable neurodegenerative diseases.

Confusion has been fueled by another 2019 measure: House Bill 1325 legalized the production and sale of hemp and some products derived from hemp that have high levels of CBD, which is non-euphoric and has low levels of tetrahydrocannabinol (or THC), the psychoactive element in marijuana.

READ MORE

The Texas PMP is a patient care tool that can be used to inform prescribing practice and to address prescription drug misuse, diversion, and overdose. As the only statewide electronic database that stores all controlled substance information, the Texas PMP helps prescribers and pharmacists avoid potentially life-threatening drug interactions, decide when to make referrals to specialty treatment providers, and identify individuals obtaining controlled substances from multiple health care providers and pharmacies. The Texas PMP shares prescription data with 30 other states/entities, allowing prescribers and pharmacists to track prescriptions dispensed outside of Texas.

READ MORE

Key findings

Data from the National Health and Nutrition Examination Survey and the Canadian Health Measures Survey

• Nearly 7 in 10 adults aged 40–79 used at least 1 prescription drug in the past 30 days in the United States (69.0%) and Canada (65.5%), and around 1 in 5 used at least 5 prescription drugs (22.4% in the United States and 18.8% in Canada).
• Among adults aged 40–59, the most commonly used drug types in the United States were antidepressants, lipid-lowering drugs, and ACE inhibitors; in Canada, they were analgesics, antidepressants, and lipid-lowering drugs.
• Among adults aged 60–79, the most commonly used drug types in the United States were lipid-lowering drugs, antidiabetic agents, and beta blockers; in Canada, they were lipid-lowering drugs, analgesics, and proton pump inhibitors.

Patterns of prescription drug use may reflect underlying patterns of health conditions and health care access in the population. Polypharmacy, often defined as the simultaneous use of five or more prescription drugs, is more common in an aging population where multiple coexisting chronic conditions often occur; however, safety concerns may arise (1). The United States and Canada share many cultural and historical ties, but with different models for health care delivery (2). This report describes the use of one or more and five or more prescription drugs among adults aged 40–79 in the United States and Canada.

Read More

The PDMP Training and Technical Assistance Center (TTAC) continuously strives to keep prescription drug monitoring programs (PDMPs) and other stakeholders informed and current on the issues that concern and impact PDMPs. Legislative and regulatory change is an area TTAC monitors in order to provide an in-depth overview of PDMPs across the United States. TTAC has compiled a complete listing of all state PDMP statutes and regulations. The report is broken down by topic area (e.g., data transmitters, authorized recipients, mandatory query provisions) for each state, territory, and jurisdiction with a PDMP. The information in the report is based on the statutes and regulations in each jurisdiction and every effort has been made to ensure its accuracy. TTAC will strive to keep the information current with routine updates. The statutory and regulatory citations included in the report are current through June 30, 2019. A copy of the report can be found here: Statutes and Regulations.

Gels, creams, and pills containing cannabidiol (CBD), the non-psychoactive, potentially therapeutic compound in the cannabis plant, have proliferated at a seemingly exponential rate in the past five years.

The industry is poised to double in growth each year between now and 2024, according to cannabis consumer research firm BDS Analytics.

But CBD is still in a regulatory gray area, with the Food and Drug Administration (FDA) in the process of wading through scientific and public commentTrusted Source to refine its regulatory strategy toward CBD products.

The Texas Department of State Health Services (DSHS) has created an online form for physicians and other health care professionals to report overdoses from controlled substances such as opioids, cocaine, and methamphetamines.

Previously, physicians reported overdoses from these “Penalty Group 1” drugs only via phone call or by faxing a paper form to the Texas Poison Center Network.

The new electronic form replaces phone and fax reporting. It is expected to make reporting and collecting overdose data more efficient, DSHS officials said.

State law requires physicians or the person in charge of a facility in which an overdose occurs or is treated to report the overdose to the DSHS.

The US Food and Drug Administration (FDA) on Monday said it would prioritize and expedite the review of generic versions of drugs indicated for the emergency treatment of opioid overdoses.

The decision follows FDA’s approval in April of the first generic of the life-saving naloxone nasal spray, commonly known as Narcan.

Under the “Public Health Emergency” prioritization factor in MAPP 5240.3, FDA says it will expedite the review of all abbreviated new drug applications (ANDAs) that reference new drug applications (NDAs) for drugs indicated for the emergency treatment of known or suspected opioid overdose. The NDAs include the Narcan injection and nasal spray, Evzio auto-injector and Revex injection.

READ MORE

The Texas State Board of Pharmacy is pleased to announce an enhancement to the Prescription Monitoring Program (PMP).

On July 17, 2019, all approved PMP users will have access to an advanced analytics and patient support tool called NarxCare. In addition to the existing PMP functionality, NarxCare will aggregate and analyze prescription information from providers and pharmacies and present visual, interactive information, as well as advanced analytic insights, machine learning risk scores and more to help physicians, pharmacists and care teams to provide better patient safety and outcomes up front, for every patient, every time. NarxCare also provides tools and resources that support patients’ needs and connects them to treatment, when appropriate.

With this enhancement, healthcare providers will have access to all features and functions of NarxCare with a consistent look and feel for users who access the solution through the PMP web portal. It also enables delivery of NarxCare within Electronic Health Records (EHR) and Pharmacy Management Systems for those prescribers and dispensers in Texas who choose to access NarxCare through integration within their healthcare IT system via Appriss Health’s PMP Gateway solution.

Instructional videos on how to navigate NarxCare and how to interpret the NarxCare score are available for viewing.

More Information About Statewide Integration

The Texas State Board of Pharmacy has partnered with Appriss Health to provide this integration option to all Texas Healthcare providers utilizing the service called PMP Gateway. PMP Gateway is a multi-state query system that provides access to a majority of state PMPs. PMP Gateway facilitates communication, information transfer, integration, and support for the state approval process, and the EHR and Pharmacy Management System vendor development process.

Integrating TX PMP AWARxE data within an EHR and/or a Pharmacy Management System provides a streamlined clinical workflow for providers. The integration eliminates the need for providers to have to log in separately to the PMP. Instead, the EHR or Pharmacy Management System automatically initiates a patient query and returns the patient's controlled substance prescription record directly within the provider's EHR or Pharmacy Management System.

LOUISVILLE, KY – July 23, 2019 – Appriss Health, provider of the most comprehensive platform for opioid stewardship and substance use disorder (SUD) in the U.S., today announced that it has partnered with the Texas State Board of Pharmacy (TSBP) to integrate prescription monitoring program (PMP) information into the electronic health record (EHR) systems of all prescribers and pharmacy management systems for all pharmacies in Texas with Appriss Health’s PMP Gateway solution. Additionally, the TSBP will make available the Appriss Health NarxCare susbstance use disorder platform designed to deliver additional clinical content to help identify patients at risk of an opioid overdose.

READ MORE

AUSTIN -- State GOP leaders have told local prosecutors not to abandon prosecution of marijuana-possession cases because of recently passed legislation legalizing hemp.

In a joint letter to district and county attorneys, Gov. Greg Abbott, Lt. Gov. Dan Patrick, Speaker Dennis Bonnen and Attorney General Ken Paxton emphasized Thursday that "marijuana has not been decriminalized in Texas." Prosecutors should not toss low-level marijuana cases, they said. In fact, the new hemp legislation gives law enforcement a new tool in pressing cases for marijuana possession, the leaders said.

READ MORE 

The Opioid-Related Emergency Department Visits dashboard was recently updated.

There are 5 tabs:

1. An Overview page that provides a general overview of data by opioid type for 2017 
2. A Data Table Builder page that lets you choose parameters to generate a data table
3. A Maps page with opioid-related emergency department visits and rates by county
4. A Data Source & Other Resources page that contains methodology behind analyzing the data
5. An Archive page that has the previous dashboard for inpatient-emergency department visits