Guidelines and Recommendations for New Jersey
The New Jersey Department of Health (NJDOH) is the primary agency in New Jersey responsible for developing treatment recommendations and educational materials for pain relief. To address the state’s opioid problem, NJDOH created the New Jersey Opioid Prescribing Guidelines in 2017 (Metzger& Metzger, 2023). The safe and efficient implementation of opioid use for the management of pain unrelated to cancer is advised by this guideline. The guidelines can be found on the NJDOH website.
New Jersey offers several tools and educational activities to tackle the opioid epidemic and encourage safer prescribing, in addition to the NJDOH recommendations. The New Jersey Opioid Task Force was created in 2017 as an effort by many government agencies and other parties to create and carry out plans to address the opioid problem (McLaughlin et al., 2024). Prescribing rules state that opioids can be prescribed to relieve pain following surgery or trauma, as well as persistent non-cancer pain when alternative non-opioid therapies have not worked or are not well tolerated (Meaden et al., 2021).
According to guidelines, opioids should be prescribed for the shortest amount of time and at the lowest therapeutic dose to treat pain (Metzger & Metzger, 2023). The recommendations advise prescription opioids for no more than three to seven days in the case of acute pain and no more than ninety days in the case of chronic, non-cancer pain before reevaluating the course of treatment.
Specific Laws on Controlled Substance Prescribing for the Nurse Practitioner
The New Jersey Controlled Dangerous Drugs Act and the rules of the New Jersey State Board of Nursing specify the powers and privileges of advanced practice nurses (APNS) to prescribe controlled drugs in the state. To prescribe restricted drugs, pharmacies need to have a current Drug Enforcement Administration (DEA) registration number (Meaden et al., 2021). APNs and licensed physicians are required to establish a collaboration agreement that outlines the physician’s scope of practice and prescribing authority.
APNs are required to keep patient records that include the reason for prescribing restricted drugs, the treatment plan, and any actions related to monitoring or follow-up, as part of the documentation requirements for managing acute and chronic pain. They are required to note in the patient’s medical file that they are aware of the NJPMP. This rule may not apply to individuals receiving hospice or palliative care, or in specific emergency scenarios.
In addition to helping the state fight the opioid crisis, APNS in New Jersey may safely and efficiently prescribe prohibited medications for the treatment of acute and chronic pain by abiding by these laws, rules, and regulations (Meaden et al., 2021). New Jersey personnel are required to check the patient’s prescribing history before prescribing a prohibited substance (Metzger & Metzger, 2023).
State Prescription Drug Monitoring Program
The NJPMP requires registration of all practitioners permitted to prescribe restricted drugs in New Jersey. Practitioners who have enrolled can view their patients’ medication histories by logging in to the NJPMP database. It is accessible to registered healthcare professionals, who can examine the history of restricted drug prescriptions for their patients. Before prescribing a prohibited medication, practitioners must consult the NJPMP, except in certain emergencies and for patients receiving hospice or palliative care (Meaden et al., 2021).
All restricted drug prescriptions issued in New Jersey are tracked by the NJPMP database, which also includes the patient’s identity, the prescribing doctor’s name, and the prescription number and date (Counts, 2024). It is required of practitioners to note in the patient’s medical record that they are familiar with the NJPMP. Only authorized healthcare professionals may access confidential NJPMP data for valid medical needs.
Laws on Medical Device Prescribing for the Nurse Practitioner
Regulations from the New Jersey State Board of Nursing specify that advanced practice nurses (APNS) are authorized to prescribe durable medical equipment (DME) or medical devices in New Jersey. Pharmacies in New Jersey are permitted to prescribe medical devices or DMEs in accordance with associate agreements with licensed physicians and within the parameters of their practice(Metzger & Metzger, 2023). However, there are some limits and requirements attached to this authorization. For the purpose of prescribing prohibited substances—which may be necessary for some DME products—APNSs must possess a current DEA registration number.
APNs are required to maintain accurate, comprehensive patient records that meet all documentation requirements to support orders for medical devices or DME. These records must include the specific item ordered, the reasoning behind the order, and any pertinent assessments of the patient’s condition (McLaughlin et al., 2024). When ordering a medical device or DME, a prescription or APN order must include the patient’s diagnosis, the item’s specifics, the quantity, and any necessary guidelines or requirements.
References
Counts, C. J. (2024). Notes from the field: Cluster of severe illness from Neptune’s fix tianeptine linked to synthetic cannabinoids—New Jersey, June–November 2023. MMWR. Morbidity and Mortality Weekly Report, 73(4), 88-90.
McLaughlin, K., Davis, J., Gonzales, M., Koh, C., Taylor, L., & Crowell, T. L. (2024). Engage, educate, escape: The New Jersey Department of Health Project Firstline Escape Room. Health Education Journal.
Meaden, C. W., Ramdin, C., Ruck, B., Nelson, L. S., Soukas, C., Hirsch, M., & Calello, D. P. (2021). The Poison Center as a pandemic response: Establishment and characteristics of a COVID-19 hotline through the New Jersey Poison Center. Clinical Toxicology, 59(12), 1228-1233.
Metzger, S., & Metzger, O. (2023). A shift left: Revised regulations for opioid prescribing in New Jersey. Journal of Medical Regulation, 109(1), 29-39.
