Publication of opioid prescription guidelines: Oregon Health Authority

THROUGH THE ORREGON – From the Oregon Health Authority: The Oregon Regional Health Authority today released Oregon's guidelines on acute opioid prescribing for the purpose of assisting clinicians working in the field of acute opioid prescribing in order to assist clinicians working in the field of acute opioid prescribing. surgical settings, dental care, primary care, emergencies and emergency care to make evidence-based prescribing decisions to treat pain.

Opioid analgesics are powerful drugs that carry risks. Although they are effective in the treatment of acute non-cancer pain, high doses and long-term use can result in dependence, abuse, overdose and death. In Oregon, five people a week die from an opioid-related overdose.

The guidelines, developed in conjunction with an external working group representing public health officials, health care and coordinated care organizations, build on Oregon's prescribing guidelines. chronic pain, published in 2016. These guidelines address the management of acute pain in novice patients. opioids. They are not intended for people currently receiving opioids or those with a history of substance use disorder.

Common examples of relevant clinical situations include: wisdom tooth extraction, sports injuries and postoperative pain management. It is common practice to prescribe 30-day prescriptions for patients in these settings. The new guidelines advise to prescribe the minimum dose of opioid short-acting effectively for up to three days, in most cases.

"While opioids are effective medications in the management of acute pain, many people do not use all the pills prescribed by their doctor after an acute event," said Katrina Hedberg, MD, head of health public at the OHA. "This tells us that patients may not need as many pills as we think, and that other forms of pain treatment may be safer and just as effective. there are a lot of excess pills in medicine cabinets, which could be misused or stolen. "

The guidelines could also help prevent the long-term dependence of opioids in patients with acute pain. According to a 2017 analysis by the Centers for Disease Control and Prevention, 30% of people who received an initial prescription of opioid analgesics for a period of 30 days remained on opioids a year later.

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In general, the guidelines recommend not using opioids as a first-line treatment for mild to moderate pain. If opioids are considered appropriate and probably effective for the patient, the guidelines emphasize the following principles:

• Evaluate the patient.
• Evaluate antecedents of long-term use of opioids or substance use disorders.
• Check out the prescription drug monitoring program, which monitors regulated substances such as opioids and benzodiazepines.
• Provide education to patients.
• Prescribe the lowest effective dose of short-acting opioids for up to three days in most cases and up to seven days for more severe acute pain.
• Follow up and reassess pain, healing and function.
• Implement, monitor and document pain management practices to ensure safety and quality of care.

Full instructions are available on the OHA website at Oregon.gov/OHA.

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