Balancing effective pain management and patient-centered opioid prescribing is a primary goal for our health care community. Opioids, medications that relieve pain, can be harmful when over prescribed or when prescribed incorrectly. In our State, hospitalizations from opioid overdose and even death from prescription opioids and heroin have increased significantly in the past ten years.[i] The Centers for Disease Control and Prevention have called this an epidemic. Listen to Dr. Wanda Filer, president of the American Academy of Family Physicians, explain what this epidemic looks like for her: www.npr.org/2015/12/30/461519814/doctors-look-to-prevent-abuse-in-midst-of-opioid-epidemic
This past year, the Bree Collaborative endorsed our State’s Agency Medical Director’s Guideline on Prescribing Opioids for Pain. This update to the 2010 guidelines expands the scope from only recommending how to prescribe opioids for chronic non-cancer pain to also addressing opioid use in acute and subacute phases and in pain around surgery. The guidelines also address special populations including sections on tapering and opioid use disorder. Read the complete guidelines on our website here: www.breecollaborative.org/wp-content/uploads/2015AMDGOpioidGuideline.pdf.
Our community, like those across the country, needs to work together to be sure that patients are receiving appropriate prescriptions. To support this goal we are forming a workgroup led by Bree Collaborative member Dr. Gary Franklin, Medical Director of the Washington State Department of Labor and Industries. The purpose of the workgroup is to design and carry out strategies to implement the guidelines. We will be discussing this new workgroup at our upcoming January 20th meeting and have scheduled workgroup meetings into 2016. Join us on the 20th or on Thursday, January 28th at 3pm to participate in our discussion. You can find more information on our meetings here: www.breecollaborative.org/meetings/
The Centers for Disease Control and Prevention has also worked to develop guidelines to improve opioid prescribing so that patients will be safer. These guidelines help our communities come to a common understanding of when opioids are appropriate, safe dosing levels, how to monitor patients to ensure safe opioid use, and when alternatives to opioids are safer and more effective long term. Read a brief fact sheet about the CDC’s Guidelines here: www.cdc.gov/drugoverdose/pdf/guidelines_factsheet-a.pdf. These guidelines are also available for public comment until January 13th here: www.regulations.gov/#!documentDetail;D=CDC-2015-0112-0001.
Our State guidelines, supported by the CDC Guidelines, help us help our community to address the opioid epidemic and will save lives.
Ginny Weir, MPH
The Dr. Robert Bree Collaborative
[i] Banta-Green C. Heroin trends across Washington State. (ADAI Info Brief). University of Washington Alcohol and other drug Abuse Institute. June 2013. Available: adai.uw.edu/pubs/InfoBriefs/ADAI-IB-2013-02.pdf. Accessed: September 2014.