The Patient Advocacy Program is a point of contact and resource coordinator for patients prescribed controlled substance medications who abruptly lose access to care.
The Patient Advocacy Program: Helping Pennsylvanians Navigate Changes in Controlled Substance Care connects with patients to learn more about concerns related to the prescribing of controlled substances, access to prescriptions, and barriers to re-establishing care with a new provider or pharmacy. It is available to help patients think through steps to address access to care barriers. The Program communicates patient feedback with internal and external stakeholders to inform coordinated, patient-centered health care in Pennsylvania.
The Patient Advocacy Program is not a health advocate program. The Program will not contact a patient’s health care provider and will not attend health care appointments. Additionally, the Department of Health cannot dictate clinical decision-making of health care providers or pharmacies.
Contact the Patient Advocacy Program
The Patient Advocacy Program: Helping Pennsylvanians Navigate Changes in Controlled Substance Care is available via email at ra-dh-advocacy@pa.gov or phone at 844-377-7367 (option 3), Monday through Friday 8 AM to 4 PM EST.
Please note, patients may choose to remain anonymous and are not required to share personal information such as their health care provider's name or prescription history. In addition, the Program does not have access to patient’s Pennsylvania Prescription Drug Monitoring Program (PDMP) record and will only know medical or prescription history if the patient chooses to share that information.
Where Patients Can Seek Care
When patients suddenly lose access to their health care provider, they may feel they have no other options but to turn to other sources to avoid withdrawal, which greatly increases the risk of overdose. We want you to know that help is available. Visit the Where to Seek Care page for more information.
Download our "Where to Seek Care" handout.
Download our "Where to Seek Care" handout in Spanish.
Avoid Withdrawal
When a patient who has been treated with a controlled substance such as opioids, benzodiazepines, buprenorphine, stimulants, etc. suddenly loses access to a health care provider or their medication, the patient may be at risk of severe physical and mental withdrawal if care is not re-established. Withdrawal symptoms happen when a patient takes less of their medication than they are used to or when they abruptly stop taking their medication.
Withdrawal symptoms do not happen because a patient has done something wrong.
The following options are recommended for finding care to manage withdrawal:
- Contact a local Single County Authority (SCA) to learn more about treatment services, including options for safely managing withdrawal. Look up the Single County Authority in your county.
- If you have health insurance, you may call the number on the back of your health insurance card or check your insurer's website to find a detoxification provider/program.
- Search online to compare treatment facilities by location, services, and insurance. Visit treatmentatlas.org.
- In case of a medical emergency, call 911 or go to your local Emergency Room immediately.
Avoid Opioid Overdose
Anyone taking opioids should carry naloxone to prevent a fatal overdose. Naloxone can reverse an opioid overdose and is available over the counter. Naloxone is also available through a state-wide standing order, which means you do not need a prescription. Most pharmacies and hospitals carry naloxone.
- Learn more about naloxone (PA Department of Health)
- Overdose: Recognize and Respond (PA Department of Health)
- Nasal Naloxone Card (PA Department of Health and PA Department of Drug and Alcohol Programs)
- Injectable Naloxone Card (PA Department of Health and PA Department of Drug and Alcohol Programs)
- Overdose Prevention Program: Offers free, life-saving supplies to communities across Pennsylvania through local partners, including naloxone to reverse opioid overdoses and test strips to detect fentanyl and xylazine.
Find Treatment
Help is available for those experiencing a substance use disorder. Call the Get Help Now Hotline at 1-800-662-4357 or visit ddap.pa.gov for treatment information.
- Overview and Phases of Treatment (Help.org) (Help.org)
- What to Expect When Calling a Helpline (Help.org) (Help.org)
- Treatment works and recovery is possible. (StartYourRecovery.org)
Patient Advocacy Program Frequently Asked Questions
The Patient Advocacy Program does not offer advocacy services related to general encounters with a health care facility or patient navigation. Read more about the goals of the Patient Advocacy Program at the top of this webpage. Consider the following resources if you or a loved one are seeking general patient advocacy resources:
- Call 211 or text your zip code to 898-211. PA 211 can connect you with a resource specialist who may be able to help you navigate your situation.
- Contact the health care system directly. Some health systems have patient advocates or social work departments.
- Contact your health insurance. Some insurance providers offer advocacy services.
- If the person requiring services is aged 65 years and above, contact your local Area Agency on Aging (AAA). County AAAs may provide advocacy services for older adults. Look up your local AAA.
- Read more about patient advocacy services on the Centers for Medicare & Medicaid Services website.
The Patient Advocacy Program does not offer medication cost assistance. Call 211 or text your zip code to 898-211. PA 211 can connect you with a resource specialist who may be able to help you navigate your situation. Pennsylvania’s PACE and PACENET programs help qualified residents, age 65 and up, get prescription medicine at a lower cost. Learn more about PACE. Additional resources may exist for patients. For example, NeedyMeds may offer drug discount cards for certain prescriptions. Search by drug on the website at needymeds.org
Contact your insurance provider directly if you have a question about coverage. If your insurance is not covering a medication or if it is too expensive, speak with your health care provider about potential alternatives. The Pennsylvania Insurance Department (PID) is available to help consumers understand their options for dealing with insurance-related questions and problems. Learn more about PID consumer services.
The Patient Advocacy Program does not handle health care facility complaints. However, the Department of Health licenses and regulates in-patient health care facilities, like nursing homes and hospitals. Learn more about these services and how to submit a complaint. Some health care facilities may also have a patient relations or guest relations department that may be able to process complaints. Contact the facility directly for more information.
According to the Distributor Settlement of July 2021, distributors (the entity that links pharmaceutical manufactures and pharmacies) must have a mechanism in place to detect suspicious orders. Suspicious orders may be orders of unusual size, frequency, or pattern. When pharmacies cite “dispensing thresholds” they may be referring to controlled substance distributor ordering thresholds.
The Department of Health (DOH) encourages pharmacies to communicate with their distributors and work collaboratively to adjust thresholds when patient volume necessitates. The distributor should be able to use this information to supply the pharmacy with medications needed to meet the demand. PA DOH does not have the authority to establish or change distributor thresholds nor compel a pharmacy to dispense a medication. Pharmacies can establish their own internal policies related to controlled substance dispensing thresholds.
Patients who are experiencing a problem with accessing their prescription are highly encouraged to seek guidance from their provider, as they may be able to speak directly with the pharmacy, prescribe an alternative course of treatment, and are a good resource for withdrawal management.
Partners
The Patient Advocacy Program involves the collaboration of multiple agencies including the Pennsylvania Department of Drug and Alcohol Programs, Pennsylvania Insurance Department, Pennsylvania Department of Human Services, Pennsylvania Association of Community Health Centers, Pennsylvania Office of Attorney General, and Pennsylvania Department of State.