About the Pledge
The Safe Prescriber Pledge (SPP) is a project of the Opioid Education and Awareness Task Force of Franklin, Hampshire, and North Quabbin. Medical professionals who sign the Pledge are supporting the public health of the region by adopting practices that ensure safe prescribing practices of potentially addictive medications.
Who can sign the Pledge? Physicians, Dentists, Surgeons, Psychiatrists, Oral Surgeons, Anesthesiologists, Orthopedists, Obstetricians, Nurse Practitioners, Nurse Midwives, Physician Assistants and others.
Signatories of the Pledge agree to:
- Make proactive use of the Massachusetts Prescription Monitoring Program (PMP)
- Utilize Patient/Provider Agreements for all patients receiving chronic opiate prescriptions
- Apply risk stratification tools to improve care of the patient and reduce risk of harm.
- Recognize that not all pain presentations require opiate pain medicine. A step-wise approach to pain management is necessary.
- Regularly assess patients with opiate prescriptions for well-being, improvement in function, and untoward side effects including sedation.
- Help ensure patients are managing their medicines appropriately without diversion, risk
- of theft, or accidental overdose to themselves or others.
- Learn to recognize symptoms of addiction and substance abuse disorder in your patients and direct them to appropriate treatment for their disease. Continued opiate prescriptions are not appropriate treatment for opiate addiction.
This page was created by the Healthcare Solutions Subcommittee of the Task Force, and provides resources to prescribers to help meet the conditions of the Pledge.
Click here for a copy of the Safe Prescriber Pledge Roster.2014.7.3
Click here for a copy of the Pledge for Short-Term Prescribers
Click here for a current copy of the List of Pledge Signatories as of 9.19.14
Click here for a copy of the Opioid Treatment Resource Guide
Links to Resources for Safe Prescribing:
Learn To Be a Better Prescriber
- Responsible Opioid Prescribing: A Clinician’s Guide, Federation of State Medical Boards http://www.fsmb.org/book/
- Safe and Competent Opioid Prescribing Education: https://www.scopeofpain.com
- Providers’ Clinical Support System for Opioid Therapies: http://www.pcss-o.org/
Massachusetts Online Prescription Drug Monitoring Program
- Prescription Drug Monitoring Program information: http://www.mass.gov/eohhs/gov/departments/dph/programs/hcq/drug-control/ma-online-prescription-monitoring-program/
- Prescriber Registration Form http://www.mass.gov/eohhs/docs/dph/quality/drugcontrol/ma-online-pmp-enrollment-form-for-prescriber.pdf
- Valley Medical group Patient/Provider Agreement
- Hilltown Community Health Center Agreement
- Boston Medical Center Agreement Form Download
- Low Literacy Medication Management Contract © Inflexxion, Inc. — available at www.painEDU.org
- Opioid Informed Consent and Agreements from the New Hampshire Medical Society http://www.nhms.org/resources/opioid
Tools to Consider When Assessing Patients
- Opioid Risk Tool — Posted with permission from Dr. Lynn Webster Download Explanatory Article Download
- Screener & Opioid Assessment for Patients with Pain © Inflexxion, Inc. Available for download after registration at www.painEDU.org. A validation study can be found here: Akbik H et al. Validation and Clinical Application of the Screener and Opioid Assessment for Patients with Pain (SOAPP). J Pain Symptom Manage 2006;32:287e293.
- Screening for Substance Abuse Disorders Using “Single” Questions
Validation 1: Smith P et al. Primary Care Validation of a Single-Question Alcohol Screening Test. J Gen Intern Med 24(7):783–8.
Validation 2: Smith P et al. A Single-Question Screening Test for Drug Use in Primary Care. Arch Intern Med. 2010;170(13):1155-1160.
- Screening for Alcohol Misuse http://www.hepatitis.va.gov/provider/tools/audit-c.asp
Reference: Bush K et al. The AUDIT Alcohol Consumption Questions (AUDIT-C): An Effective Brief Screening Test for Problem Drinking. Arch Intern Med. 1998;158:1789-1795.
- Current Opioid Misuse Measure – © Inflexxion, Inc. Available for download after registration at www.painEDU.orgValidation: Butler SF et al. Development and validation of the Current Opioid Misuse Measure. Pain 130(2007):144–156.
- PHQ 9 to Screen for Mental Illness: Link to UMass Medical: http://www.umassmed.edu/Content.aspx?id=96774
- PHQ 2 : Provided by the Utah Department of Health Download
- PEG Scale: Validation Study and Scale: Krebs EE et al. Development and Initial Validation of the PEG, a Three-item Scale Assessing Pain Intensity and Interference. J Gen Intern Med 24(6):733–8.
- Brief Pain Inventory and Brief Pain Inventory Short Form – © MD Anderson Cancer Center http://www.mdanderson.org/education-and-research/departments-programs-and-labs/departments-and-divisions/symptom-research/symptom-assessment-tools/brief-pain-inventory.html
How to Interpret Urine Drug Screens
- Urine Drug Testing in Clinical Practice – 5th Edition. Available as an accredited CME activity from the CAFP website http://www.pharmacomgroup.com/udt/udt5.pdf. Physicians can receive 2 hours of Category 1 credit (acceptable for 2 Prescribed credits by AAFP) for reading the monograph and completing the self-assessments questions located on the website.
- Drug Retention Times — U.S. Department of Energy: ORISE Download
Narcan Prescribing and Overdose Prevention
- Information on prescribing naloxone http://prescribetoprevent.org/
- SAHMSA Overdose Prevention Toolkit http://store.samhsa.gov/product/SMA13-4742
For more information, please contact the Task Force Coordinator.