Department of Public Health

 

Monroe County, New York

 

Cheryl Dinolfo Michael D. Mendoza, MD, MPH, MS
County Executive Commissioner of Public Health
09/18/2017

Dear Colleague,
As the Deputy Commissioner of the Monroe County Department of Public Health, I write to you

to ensure that all providers in our area are well informed about ways they can combat the opioid
epidemic that is inundating our local region and the country as a whole.

As I'm sure you are well aware, the number of people addicted to narcotic medication, or their
illicit analogues, is increasing at an alarming rate. Concomitantly, the number of deaths by opioid
overdose is also increasing. This problem affects Monroe County residents from every suburb, town
and the City of Rochester. Whether they have shared it with you or not, it is very likely that some of
your patients are affected by this problem.

As healthcare providers we can address this issue by prescribing opioid pain medication
appropriately. In addition to creating guidelines for prescribing opioids, the CDC has developed a
mobile app, pocket card, non-opioid treatment guide for chronic pain, checklist for prescribing opioids,
fact sheets and multiple training webinars and videos about the topic. These resources can be found at
s: ov dru overdose rescribin roviders.html or by simply googling CDC and opioid
guidelines. We can also inform patients about the addictive nature of opioid medications whenever we
prescribe them.

Another strategy to address this issue is to consider prescribing naloxone (e.g an
opioid overdose reversal drug, whenever we prescribe any opioids. Overdoses can happen when
patients misunderstand directions and accidentally take too much medication, grab the wrong bottle,
or when family members get into a patient?s medicines. Thus, i see every prescription for an opioid as
an opportunity to also provide naloxone. In order to make naloxone more widely available, a standing
order is available in all pharmacies which allows them to diSpense nasal naloxone to any person who
asks for it, without a prescription. While the medication is billed through a person?s insurance,
individuals should not worry that this will indicate that they have a substance abuse disorder.
Requesting naloxone from a pharmacy will not change an individual?s personal medical record.

For those patients whose co-payment might be a barrier to obtaining this medication, the NYS
Department of Health has implemented the Naloxone Copayment Assistance Program, (NCAP). NCAP
allows a pharmacy to bill the DOH for up to $40 of a co?payment for Naloxone, whether it is prescribed
to an individual or provided under the non-patient specific standing order (see canned copy of NCAP
billing pamphlet). Palm ards and brochures about both these programs can befordered from NYS at no
cost by emailing BOOleQhealth.ny.gov. Even if you do not prescribe naloxone, please inform your
patients of these two initiatives so that anyone can obtain this life-saving antidote and be prepared to
act in case they witness a person passing out in a public library, restaurant, sporting event, anywhere.

I I Westfall Road Rochester, New York 14620
wwu'.mom'oecoumy.gov

Department of Public Health

 

Monroe County, New York

 

Individuals without insurance can obtain a free kit containing 2 doses of Naloxone by attending
free, regularly scheduled trainings offered by the Monroe County Department of Public Health, Strong
Behavioral Health or Trillium Health. The Monroe County Department of Public Health can be reached
at (585)753-2991 or emailing mchealth@monroecounty.gov. To find out when the next available
weekday training will take place, contact Michele Hermann at (585) 275-1829 or
Michele Herrmann@urmc.rochester.edu . For weekend trainings, contact Trillium Health at
OOP@trilliumhealth.org.

By prescribing opioids judiciously, educating our patients properly, and sharing the above
information broadly, we can all contribute to protecting our patients and communities from overdose
deaths due to opioids. If you have any questions, want to learn more about how to order NCAP
materials to display in your office, or our office can be of assistance to you around this topic, please do
not hesitate to reach out to me at or 585-753-2989.

Thanks very much.

Marielena V?lez rown, MD, MPH
Deputy Commissioner of Public Health
Monroe County Department of Public Health

I Westfall Road - Rochester, New York 14620
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