Opioid prescribing principles can help doctors fight the epidemic
The opioid epidemic has become an unprecedented crisis, says Dr. Halee Fischer Wright, president and CEO at MGMA. “Through our research, we’ve put forward both current best practices for, and barriers to, preventing prescription opioid abuse and treating addiction,” she adds.
The association suggests three ways to support development of an effective opioid prescription policy:
* Lines of communication must be open and clear between all parties, including patients, providers, staff members and pharmacists. This helps ensure all parties understand proper use of opioids and can recognize potential misuse.
* Opioid prescription policies are more effective when teamed with information technologies that support prescription drug monitoring programs that can identify patients who receive opioids from other providers. Use of electronic prescriptions for controlled substances improves tracking of scripts and prevention of fraudulent prescriptions being filled.
* Providers with an understanding of the capabilities and limitations of specialists they refer patients to are more likely to have their patients receive appropriate care, which can reduce the risk of turning to opioids to manage pain rather than treating underlying causes.
MGMA further has developed six principles physician practices should follow when developing or modifying opioid prescription policies:
* Opioids should not be a first-line therapy for chronic pain. If benefits outweigh risks, opioid therapy should be combined with nonpharmacologic therapy and non-opioid pharmacologic therapy.
* Treatment plans should include when and how opioid therapy is discontinued as patients get near their goals.
* Maintain continuing education and evaluation of patients on an ongoing basis. Evaluation of benefits and harms of opioids should be done one to four weeks after start of therapy and after any dosage increase.
* Immediate-release opioids at the lowest effective dosage are preferred for starting therapy.
* Clinicians should use state prescription drug monitoring program data before starting an opioid therapy and periodically afterward. Also, urine drug testing should be done before the start of therapy.
* Physicians should be ready to offer and arrange treatment for patients with opioid dependencies, which often includes buprenorphine or methadone along with behavioral therapy.
The complete report from MGMA is available for purchase here.