8.31.16: Letter From the Surgeon General Calls Safe Prescribing Education Advocates to Action
I am asking for your help to solve an urgent health crisis facing America: the opioid epidemic. Everywhere I travel, I see communities devastated by opioid overdoses. I meet families too ashamed to seek treatment for addiction. And I will never forget my own patient whose opioid use disorder began with a course of morphine after a routine procedure.
It is important to recognize that we arrived at this place on a path paved with good intentions. Nearly two decades ago, we were encouraged to be more aggressive about treating pain, often without enough training and support to do so safely. This coincided with heavy marketing of opioids to doctors. Many of us were even taught – incorrectly – that opioids are not addictive when prescribed for legitimate pain.
The results have been devastating. Since 1999, opioid overdose deaths have quadrupled and opioid prescriptions have increased markedly – almost enough for every adult in America to have a bottle of pills. Yet the amount of pain reported by Americans has not changed. Now, nearly 2 million people in America have a prescription opioid use disorder, contributing to increased heroin use and the spread of HIV and hepatitis C.
I know solving this problem will not be easy. We often struggle to balance reducing our patients’ pain with increasing their risk of opioid addiction. But, as clinicians, we have the unique power to help end this epidemic. As cynical as times may seem, the public still looks to our profession for hope during difficult moments. This is one of those times.
That is why I am asking you to pledge your commitment to turn the tide on the opioid crisis. Please take the pledge. Together, we will build a national movement of clinicians to do three things:
First, we will educate ourselves to treat pain safely and effectively. A good place to start is this pocket guide with the CDC Opioid Prescribing Guideline. Second, we will screen our patients for opioid use disorder and provide or connect them with evidence-based treatment. Third, we can shape how the rest of the country sees addiction by talking about and treating it as a chronic illness, not a moral failing.
Years from now, I want us to look back and know that, in the face of a crisis that threatened our nation, it was our profession that stepped up and led the way. I know we can succeed because health care is more than an occupation to us. It is a calling rooted in empathy, science, and service to humanity. These values unite us. They remain our greatest strength.
Thank you for your leadership.
8.17.16: New Letter from the NYS Department of Health Regarding Detox and Treatment of Opioid Addiction
Legislation Enacted Regarding Drugs Used for Detoxification or Maintenance Treatment of Opioid Addiction in Medicaid Fee-for-Service (FFS) & Medicaid Managed Care
Per changes to Social Services Law section 364j, and Public Health Law section 273, prior authorization is not allowable for initial or renewal prescriptions for preferred or formulary buprenorphine or injectable naltrexone when used for detoxification or maintenance treatment of opioid addiction. Food and Drug Administration (FDA) and Compendia supported frequency, quantity and/or duration limits may continue to be applied.
To obtain preferred/formulary drug listings and plan limitations please see the following websites:
8.1.16: New York Law Limiting Initial Opioid Prescribing Went Into Effect Friday, July 22
In an effort to curb prescription opioid abuse, New York passed legislation that limits prescriptions of Schedule II, III, or IV opioids to seven days upon initial consultation or treatment of acute pain. This new law will go into effect on Friday, July 22, 2016. Here are additional details:
Additional information on opioids and this law may be obtained by contacting the NYS Department of Health’s Bureau of Narcotic Enforcement at 1-866-811-7957 or by clicking here.
3.17.16: Patient Education: ACP Develops Safe Opioid Use Resources
In response to public health concerns over the adverse impact of opioid misuse, two new patient education resources have been developed by ACP.
The “Patient FACT” sheet on Safe Opioid Use answers the following questions:
The “Patient FACT” sheet on Chronic Pain provides responses to:
Please feel free print out these documents for distribution to your patients.
11.24.15 CDC Issues Recommendations for Prescribing Opioids for Chronic Pain
The Centers for Disease Control and Prevention (CDC) issued 12 recommendations about opioid prescribing for primary care clinicians treating adult patients with chronic pain outside of active cancer treatment, palliative care, and end-of-life care.
The recommendations are intended to improve communication about the benefits and risks, improve safety and effectiveness of pain treatment, and reduce risks associated with long-term opioid therapy. They were published March 15 by the Journal of the American Medical Association.
The recommendations focused on 3 areas:
Starting or continuing opioids for chronic pain
Opioid selection, dosage, duration, follow-up, and discontinuation
Assessing risk and addressing harms of opioid use
Pri-Med Opioid Screening Online Course Now Available
ACP developed online training modules with Pri-Med to educate clinicians about best practices when prescribing opioids to patients and to help prescribers manage risk for abuse and inappropriate use. The REMS training modules provide comprehensive educational information for primary care clinicians, and can be completed for CME credit. Access the online modules for additional information.
A brief video from Steven Weinberger, MD, FACP, executive vice president and CEO of ACP, highlights the initiative’s goal of reducing misuse, abuse and overdose deaths associated with prescription opioids.
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Last Updated 1.31.19
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