The problem: Opioid abuse, misuse, and overdoses are increasing, both in Pennsylvania and nationally. Opioid overdoses accounted for nearly 2,500 deaths in Pennsylvania in 2014 – that’s nearly 7 people a day – and indications are that those numbers are climbing.
The solution: A multi-pronged approach that includes physicians, patients, and health care organizations like the Pennsylvania Medical Society (PAMED) working collaboratively to address this growing epidemic.
PAMED recently launched its Opioids for Pain: Be Smart. Be Safe. Be Sure. initiative, which focuses on patient empowerment and physician education. This initiative consists of a five-step physician call to action and seven questions patients should ask when prescribed an opioid.
The Physician Call to Action ― All Pennsylvania physicians should take these five steps:
- Know the prescribing guidelines. They are available on PAMED’s website at pamedsoc.org/OpioidResources. The first session in PAMED’s online CME series focuses on the guidelines. In this session, analyze your prescribing practices against statewide guidelines and identify when and why to prescribe opioid medications. Get the CME at www.pamedsoc.org/OpioidsCME.
- Use Pennsylvania’s prescription drug monitoring program (PDMP) once it’s up and running (it’s expected to be operational in August 2016). The fourth session in PAMED’s online CME series will address common physician questions regarding governance, user access, and provider and dispenser reporting requirements. Watch PAMED’s Daily Dose email for when this session is available.
- Refer patients who have a substance use disorder to treatment. Referral to treatment is covered in the third session in PAMED’s online CME series. This session addresses substance use disorders; explores screening and assessment tools; reviews intervention strategies; and assesses best practices in referrals to specialists, rehabilitation services, and community resources. Get the CME at pamedsoc.org/OpioidsCME.
- Discuss alternatives to opioids with patients.
- Ask patients to keep their pills safe, and properly dispose of a prescribed medication when they no longer need it. A list of drug take-back locations is available at https://apps.ddap.pa.gov/GetHelpNow/PillDrop.aspx.
Patient Empowerment ― Patients should ask these seven questions when prescribed a pill for pain:
- Is this prescription an opioid?
- At what level of pain should I take this prescription?
- Do I have to take every pill in the prescription?
- Where can I safely dispose of remaining pills?
- What can I do to avoid addiction?
- What are possible warning signs of dependence or addiction?
- What can I do if I believe that I might have developed a dependence on this drug?
Resources for physicians, patients, and lawmakers are available at www.pamedsoc.org/OpioidInfo.
“We need to make sure that we ― as physicians ― are doing everything we can to stop this wave of abuse, and empowering our patients to do the same,” said PAMED Board Chair David Talenti, MD.
“If physicians don’t suit up for the battle, who will?” he asks. “Education is a silver bullet.”
In addition to the above-mentioned educational sessions, PAMED’s online CME series also has a session on naloxone. This session addresses the use of naloxone as an opioid antidote, reviews regulatory requirements for prescribing naloxone to third-party first responders, and assesses naloxone prescribing options.
PAMED is collaborating with the Pennsylvania Department of Health and 11 other health care associations on this educational series.
“I think that we have to understand this is a public health crisis and we all have a role to play in terms of solving this,” said PAMED member and Pennsylvania Physician General Rachel Levine, MD.
“This crisis hits everyone ― our mothers, fathers, brothers, sisters, sons, daughters, rural, urban, suburban,” she said. “We have to get past the idea that this is someone else’s problem. We have to get people into treatment and recovery. “Addiction is a medical illness. It is not a moral failing. We have to erase the stigma.”
PAMED’s educational series seeks to address the many layers and complexities of this crisis. Learn more and get CME credit by visiting www.pamedsoc.org/OpioidsCME. Access additional resources such as prescribing guidelines in PAMED’s Opioid Abuse Resource Center at www.pamedsoc.org/OpioidResources.