Mo. Providers Release 10 Action Steps to Reduce Painkiller Abuse

Dec. 01--Six major health care provider groups in Missouri have released recommendations on how their members can reduce opioid painkiller addiction across the state.

Research released earlier this year found hospital treatment for commonly-prescribed opioid painkillers increased 137 percent in Missouri over the last 10 years, mainly because of overuse.

"Missouri doesn't have a comprehensive policy to address opioid misuse and abuse," said Christopher Howard, hospital operations president at SSM Health and board chair of the Missouri Hospital Association. "There are limited options available to identify appropriate use of these necessary but powerful painkillers."

The action steps were developed by the Missouri associations representing doctors, family physicians, osteopathic physicians, emergency physicians, dentists and hospitals. Recommendations include:

• A focused pain assessment prior to determining a treatment plan. The assessment should include risk factors for addiction and the incorporation of non-narcotic remedies.
• Diagnoses based on evidence-based guidelines.
• Use non-narcotic treatment of symptomatic, non-traumatic tooth pain.
• Treatment of patients with acute exacerbation of existing chronic pain should begin with an attempt to contact the primary opioid prescriber or primary care provider if possible.
• Opioid prescriptions for chronic conditions, including acute exacerbation of existing chronic pain, should be limited to no more than 72 hours.
• For new conditions requiring narcotics, the length of the opioid prescription should be at the provider's discretion. Limit the prescription to the shortest duration needed that effectively controls the patient's pain. Outpatient access to follow-up care should be taken into consideration.
• Emergency department physicians should not provide prescriptions for controlled substances that are claimed to be lost or destroyed
• Emergency department physicians should not prescribe long-acting or controlled-release opioids unless clinically indicated. Provide tamper-resistant forms of opioids.
• When narcotics are prescribed, staff should counsel patients on proper use, storage, and disposal of narcotic medications.
• Beyond the emergency department, health care providers should encourage policies that allow dispensing naloxone to public health, law enforcement and family as an antidote for opioid overdoses.

Michele Munz -- 314-340-8263

@michelemunz on Twitter

mmunz@post-dispatch.com

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