By Ed Coghlan.
The Oregon Health Authority has issued opioid prescribing guidelines for acute pain patients not currently using opioids.
The guidelines are aimed at patients receiving care from dentists, emergency room and primary care physicians as well as some post procedure/surgical care.
The OHA has been in the news this year for recommending policy that would force taper Medicaid patients off opioids in one year, a recommendation that has received considerable criticism from the chronic pain community and many providers who treat them.
The Oregon Acute Opioid Prescribing Guidelines are not designed to impact pain therapy for cancer patients, palliative care or end of life considerations.
The OHA document cites there has been a “30% reduction in opioid prescribing in Oregon since 2012 and yet prescribing rates remain high”, indicating that 20% of all Oregon residents received at least one opioid prescription in 2017.
According to the report, “opioids should NOT be considered as first line therapy for mild to moderate pain. Mild to moderate pain can often be treated without opioids by recommending over-the-counter medications, and physical treatments such as ice and immobilization. If non-opioid interventions are ineffective and opioids are appropriate, prescribe the lowest effective dose of short-acting opioids for less than 3 days; incases of more severe acute pain, limit initial prescription to less than 7 days.
These guidelines would reduce the number of opioid pills in “circulation”.
“While opioids are effective medications in acute pain management, many people do not use all of the pills that are prescribed by their doctors after an acute event,” said Katrina Hedberg, MD, state health officer at OHA. “What this tells us is that patients may not need as many pills as we think, and other forms of pain management may be safer and just as effective. It also tells us that there are many excess pills sitting in medicine cabinets, which could be misused or stolen.”
For National Pain Report coverage on the forced taper proposal, click here.