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Who else has prescribed opioids for your patients?

All local prescribers should use the Idaho or Washington Prescription Monitoring Program (PMP) to avoid duplicating a prescription for opioids or other controlled substances.

Since some care crosses state lines, it is anticipated that by the end of 2018, providers will be able to access the PMP for a neighboring state.

To help prevent potential drug interactions, use these best practices for getting accurate medication histories from your patients. 

Utilization Maps

Several entities have mapped opioid-related measures, including:

Centers for Medicare & Medicaid Services

Qualis Health

Washington Prescription Monitoring Program

Below, we have compiled a sampling of some of the tools available for appropriate opioid prescribing. Other resources more generally related to preventing adverse drug events are also available on our website.

Research

Effect of a Single Dose of Oral Opioid and Nonopioid Analgesics on Acute Extremity Pain in the Emergency Department: A Randomized Clinical Trial
A recent study, published November 2017 in JAMA, demonstrates that non-opioid medications can be as effective as opioids for acute pain.

Efficacy, Tolerability, and Dose-Dependent Effects of Opioid Analgesics for Low Back Pain: A Systematic Review and Meta-analysis
This 2016 analysis, published in JAMA, finds no evidence on opioid analgesics for acute low back pain, or to guide treatment with opioids for chronic low back pain.

Opioids Compared to Placebo or Other Treatments for Chronic Low-Back Pain
A Cochrane data review found that only a limited number of studies had been done to compare efficacy of opioids versus NSAIDs, and of those that had been completed, there were no differences between the two classes of drugs. It cautions against using opioids for long-term management of low back pain.

Opioid Prescribing After Nonfatal Overdose and Association With Repeated Overdose: A Cohort Study  
A 2016 study published in the Annals of Internal Medicine found that nearly all patients continued to be prescribed opioids following a nonfatal overdose.

State-Specific Regulations and Policies

(WA) ESHB 1427
Opioid prescribing legislation currently under development and scheduled for adoption in the fall of 2018

Idaho Opioid Misuse and Overdose Strategic Plan

Washington State Opioid Response Plan

Guidelines

CDC Guideline for Prescribing Opioids for Chronic Pain
Published in March 2016, the CDC guideline provides recommendations about the appropriate prescribing of opioid pain relievers and other treatment options to improve pain management and patient safety. Read the full guidelines, download a brief summary and the prescribing checklist, and get other related resources.

Ohio Governor's Cabinet Opiate Action Team
Prescribing guidelines, patient screening tools, and other clinical resources

Review the recommendations of nine different professional associations related to specific uses of opioid medications.

Pain assessment and treatment recommendations—especially for treating older adults, those with dementia, and differentiating between nociceptive and neuropathic pain.

FDA Safety Letter warns of the dangers of taking benzodiazepines and opioid medications concurrently.

Pain Assessment and Tracking

These resources were picked specifically for the nursing homes we are assisting, but many could be adapted to other settings as well.

Dose Equivalence Calculators

Web version, produced by the Washington State Agency Medical Director's Group

Smart phone app, produced by the Australian and New Zealand College of Anaesthetists

Consultations (for WA providers)

University of Washington
Pain and Opioid Consult Hotline for Clinicians

Clinicians located in Washington who are treating patients with complex pain medication regimens can get free consultations with UW pain specialists.

Patient Education

Patient education brochure produced by the ABIM Foundation and Consumer Reports regarding pain management and risks of opioid medications.