Intranasal Naloxone Prescription Requirement at Discharge

In January 2022, the HMH Pain Committee set forth a process to comply with the state mandate requiring all providers to co-prescribe naloxone to any patient receiving opioids for the management of chronic pain if the patient has one of the following:

• A discharge prescription(s) totaling ≥ 90 morphine milligram equivalents (MME) per day
• Is taking an opioid and a benzodiazepine concomitantly

Thanks to the feedback from our Medical Staff, the alert system set up in Epic has been refined to notify providers only when opioid use has been stipulated as chronic by the provider and/or long acting opioids are prescribed. This will include previously prescribed opioid prescriptions and will fire for inpatients at the time of discharge only. MME calculations will appear as below:

Effective October 17, 2022, all patients that meet the above criteria will have a best practice alert (BPA) fire upon discharge medication reconciliation to remind the provider to order intranasal naloxone. 

The spirit of this legislation is to improve accessibility to naloxone to prevent opioid-related deaths. Therefore, this process is structured that any HMH provider will be responsible for ordering naloxone regardless of whether or not they are the prescriber who ordered the opioid.