Moderator: John L. Eadie, MPA, Coordinator, Public Health and Prescription Drug Monitoring Program Project, National Emerging Threat Initiative, A National HIDTA Initiative, and Member, National Rx Drug Abuse & Heroin Summit Advisory Board
CE Certified By: AMA,AAFP,ACPE,ADA,ANCC,APA,NAADAC,NASW,NBCC
Despite recommendations within recent guidelines for patient-centered evaluation of the risks and benefits for prescribing opioids for chronic pain, there are concerns regarding the effectiveness of initiatives solely focused on opioids that do not consider co-morbid conditions, such as initiatives from some state regulators, insurers, payers and healthcare organizations that encourage blanket opioid dose reduction or discontinuation. These concerns are especially pronounced for patients with mental health or substance use disorders (MH/SUD) for whom risk for overdose or suicide still exist even when opioids are no longer prescribed. Due to these concerns, the Department of Veterans Affairs (VA) is analyzing national data and have found:
1. Limitations of using morphine equivalent daily dose (MEDD) as a singular population-based risk mitigation strategy given that in fiscal year 2013, VA patients prescribed less than 90 MEDD accounted for 93% of patients and 79% of overdose/suicide-related deaths.
2. A significant decrease in follow-up year overdose mortality between FY2011 and FY2014 among VA patients prescribed opioids in FY2010 and FY2013 (no significant change in suicide mortality).
Presenters will offer practical suggestions to treat patients prescribed opioids for chronic pain and discuss future analyses. These findings underscore that patients at risk for overdose/suicide tend to be complex patients with multiple comorbidities — especially MH/SUD conditions — and that a multifaceted risk mitigation approach is needed to improve patient safety.
UPON COMPLETION OF THIS COURSE, PARTICIPANTS WILL BE ABLE TO:
- Recognize that most patients who are prescribed opioids who end up dying from overdose or suicide are below 90 mg morphine equivalent daily dose and have a mental health or substance use disorder.
- Identify strategies for addressing opioid prescribing among complex patients on long-term opioids for chronic pain.
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