Message Regarding Opioids from Florida Department of Health

Dear Colleagues,

As health care professionals, we have a crucial role in ensuring the best possible care for our patients and communities, including optimal and safe pain management. In 2015, there were more than 33,000 deaths nationwide and nearly 3,900 deaths in Florida attributed to opioid overdoses. I'd like to share with you current steps the Department of Health (Department) is taking to combat and prevent opioid addiction and overdoses, and the important role you can play in the statewide solution.

At the direction of Governor Rick Scott, in May, along with the Department of Children and Families - the lead agency for substance use and addiction - and the Florida Department of Law Enforcement, I participated in a series of opioid workshops in communities around the state. We heard valuable feedback from local leaders and community members in Palm Beach, Manatee, Orange, and Duval Counties. Numerous parents shared their heartbreak of losing a child to opioid overdose, and the dismay of knowing it may have started with a prescription from a health care professional.

Following the workshops, Governor Scott signed an Executive Order directing a Public Health Emergency across the state for the opioid epidemic, which directed me to issue a standing order for naloxone for emergency responders to help save lives. The order also directed the Department of Children and Families to immediately draw down the $27 million federal grant awarded to the agency to provide prevention, treatment and recovery support services to address this epidemic. The Florida Department of Law Enforcement’s focus remains stopping the introduction, sale and use of illegal opioids. The Department is committed to supporting the efforts of our partner agencies.

Many of us were trained to assess pain as the fifth vital sign; the potential consequences of opioid addiction for some patients after only a few days was not known. Late last year, CDC released opioid prescription guidelines which provide recommendations for primary care clinicians who are prescribing opioids for chronic pain outside of active cancer treatment, palliative care, and end-of-life care. I ask you to review these recommendations and adjust your approach to pain management when appropriate. The Department also developed a patient-centered brochure to highlight the risks associated with opioid use. We share this brochure with you as a helpful resource with information you can share with your patients.

The Department's Division of Medical Quality Assurance is tasked with administering the Prescription Drug Monitoring Program (PDMP), which supports sound clinical prescribing, dispensing and use of controlled substances. In 2016, there were nearly 200 million controlled substance prescription dispensing records maintained in the PDMP, and there were 36,718 registered health care practitioners in the system.

This spring, a bill was passed by the Florida Legislature and signed into law by Governor Rick Scott that expands PDMP access to allow employees from the Department of Veterans Affairs to review a patient's dispensing history. The new law also requires a dispenser to upload controlled substance dispensing information by the close of business the following day. The Legislature also ensured adequate funding for the program's future. The PDMP is an important resource for clinicians, allowing you to view patients controlled substance dispensing history, leading to more responsible prescribing practices. I urge you to utilize this program and refer to PDMP records as you treat patients.

Recently, I met jointly with members from the Boards of Medicine, Osteopathic Medicine, Dentistry, Pharmacy and Nursing to discuss other proactive steps we can take as clinicians to protect our patients. I have also had productive conversations with our professional associations. Timothy Stapleton, CEO of the Florida Medical Association, recently issued an editorial entitled Fighting the Opioid Epidemic in the Exam Room, which I encourage you to read.

As the Department continues to work with other state agencies and partners statewide to combat opioid addiction and overdoses, I look forward to sharing additional actions and ways we can collaborate in the coming months. Our patients are looking to us to be leaders in addressing the opioid epidemic, and I thank you in advance for being a part of the solution.

Respectfully, Celeste Philip, MD, MPH Surgeon General and Secretary