Current through Register Vol. 50, No. 9, September 20, 2024
A. Purpose and Applicability
1.Pursuant to
R.S.
40:978.2, to protect public health and
safety, the Department of Health and Hospitals sets forth the following
training and monitoring requirements for a licensed medical practitioner who
prescribes, dispenses, or administers naloxone or another opioid antagonist to
a person reasonably believed to be undergoing an opioid-related drug
overdose.
2.Training and monitoring
requirements of this Rule shall apply to licensed medical practitioners when
dispensing or distributing opioid antagonists to third parties who will be
administering the medication. Training shall include how to recognize signs of
overdose indicating when it is appropriate to utilize naloxone or another
opioid antagonist, standards for storage and administration of the medication,
and instructions for emergency follow-up procedures.
3.First responders as defined in
R.S.
40:978.1 are exempt from the training
requirements as detailed in this Rule.
4.Prescribers are strongly encouraged to
co-prescribe naloxone or another opioid antagonist once in a given year to
persons receiving opioid therapy for greater than 14 days.
B. Definitions
Department-the Department of Health and
Hospitals. Licensed Medical Practitioner-a physician or other
healthcare practitioner licensed, certified, registered, or otherwise
authorized to perform specified healthcare services consistent with state
law.
Opioid Antagonist-agents such as
naloxone that have high affinity and bind to opiate receptors but do not
activate these receptors. This effectively blocks the receptor, preventing the
body from responding to opioids and endorphins. These drugs block the effects
of externally administered opioids. Opioid-Related Overdose-a
condition including extreme physical illness, decreased level of consciousness,
respiratory depression, coma, or the ceasing of respiratory or circulatory
function resulting from the consumption or use of an opioid, or another
substance with which an opioid was combined.
SAMHSA-the Substance Abuse and Mental
Health Services Administration.
Toolkit-the SAMHSA opioid overdose
toolkit. Reference available online through SAMHSAs website.
C. Training Requirements
1.At minimum, licensed medical practitioners
shall provide the following information and training regarding signs of
overdose when prescribing, distributing, or dispensing an opioid antagonist.
a. Signs of overdose, which often results in
death if not treated, include:
i. face is
extremely pale and/or clammy to the touch;
ii. body is limp;
iii. fingernails or lips have a blue or
purple cast;
iv. the patient is
vomiting or making gurgling noises;
v. he or she cannot be awakened from sleep or
is unable to speak;
vi. breathing
is very slow or stopped;
vii.
heartbeat is very slow or stopped.
b. Signs of overmedication, which may
progress to overdose, include:
i. unusual
sleepiness or drowsiness;
ii.
mental confusion, slurred speech, intoxicated behavior;
iii. slow or shallow breathing;
iv. pinpoint pupils;
v. slow heartbeat, low blood pressure;
and
vi. difficulty waking the
person from sleep.
c. For
additional guidance and information, please reference the most recent version
of the SAMHSA opioid overdose toolkit.
2.At minimum, licensed medical practitioners
shall provide the following information and training regarding storage and
administration when prescribing, distributing, or dispensing an opioid
antagonist:
a. instructions on storage of the
opioid antagonist in accordance with the manufacturer instructions;
b. instructions on administration of the
opioid antagonist in accordance with the instructions printed on or distributed
with the device by the manufacturer.
3.At minimum, licensed medical practitioners
shall provide the following information and training regarding emergency and
follow-up procedures when dispensing or prescribing an opioid antagonist.
a. Prior to administration, the person
administering the opioid antagonist shall immediately call 9-1-1 for emergency
medical services if medical assistance has not yet been sought or is not yet
present.
b. After calling for
emergency services and administering the opioid antagonist, emergency follow-up
procedures shall be conducted in accordance with the guidelines set forth in
the SAMHSA opioid overdose toolkit.
c. Upon stabilization by emergency medical
services, the treating practitioner shall refer the patient to and offer
information regarding substance use treatment services.
AUTHORITY NOTE:
Promulgated in accordance with
R.S.
40:978.2.
