New Mexico Nurse-Midwives' Controlled Substance Prescribing and Monitoring Practices

Introduction New Mexico, a state with a high incidence of opioid overdose deaths, requires certified nurse-midwives (CNMs) who prescribe controlled substances to use the statewide Prescription Monitoring Program (PMP). This study examined how frequently CNMs who practice in New Mexico and prescribe controlled substances use the PMP and the purposes for which they use it. Methods All CNMs licensed in New Mexico (N = 210) were sent a link to an anonymous online survey. CNM demographics, practice characteristics, and controlled substance prescribing practices were examined. Results Approximately 40% of CNMs licensed in New Mexico completed the survey (N = 83), 77% of whom (64/83) were providing direct clinical care services. Nearly all who were engaged in clinical care had a US Drug Enforcement Administration registration number and were registered in the PMP (97%; 62/64). Approximately 90% of those respondents (56/62) reported prescribing controlled substances. Approximately 10% (6/62) never logged into the PMP, 40% (25/62) never ran a self-report, and nearly 30% (18/62) reported never checking the PMP for patient alerts. Among those who reported prescribing controlled substances, the percentages who never logged in, never ran a self-report, and never checked for patient alerts were 7% (4/56), 37% (21/56), and 27% (15/56), respectively. Nearly half of those prescribing controlled substances (26/56) did so monthly or more often, but with respect to their own prescribing, approximately one-third of them (9/26) checked the PMP less frequently than every 6 months. Discussion Most CNMs in New Mexico are authorized to prescribe controlled substances, but the frequency of prescribing varies, and some CNMs may not be making optimal use of the state PMP for self-reports, for patient alerts, or prior to prescribing a controlled substance. Additional education pertaining to the PMP is needed, as are best practice recommendations for monitoring CNMs' controlled substance prescribing.