CDC Opioid Guidelines Sheds Light on Conflicting Expert Opinions

The CDCs latest opioid prescribing guidelines, released this March, were created with the goal of achieving balance between the analgesic and addictive properties of opioid analgesics, to uphold the safety as well as meet the pain management needs of the public at large. Unfortunately, the controversy surrounding these guidelines points to a detrimental issue at the crux of their implementation: A fractured field – two expert, yet conflicting, schools of thought on the current opioid policy.

• Treating chronic pain with a wider range of treatments, as opposed to relying mainly on opioid regimens.
• Avoiding the use of high dose prescriptions, as well as the combined prescription of opioids and benzodiazepines, to reduce the risk of overdose.
• Providing addiction treatment when necessary (methadone, buprenorphine).

There are two conflicting schools of thought regarding treatment approaches to opioids…

1. Reduce Pain and Suffering.
   This paradigm stems from an aggressive movement in the 1990s wherein physicians trained in pain management and palliative care were instructed to be sympathetic to pain. Enforced by the belief that those in true pain would not become addicted and reinforced by pharmaceutical companies and federal agencies pointing to pain as “the fifth vital sign,” this movement missed the boat on understanding the serious risks of opioid addiction.
2. Prevent and Treat Addiction.
   Driven by addiction specialists, who lacked an understanding of the seriousness of debilitating and chronic pain and whose priorities were vastly different than pain and palliative care physicians, practitioners of this model had a more thorough understanding of the addictive risks of opioid regimens. They watched the sales of opioid prescriptions quadruple from 1999-2010 - alongside the rate of overdose deaths. Though the need for a rapid public health response remained apparent, insufficient evidence on safe stoppage procedures for opioid regimens existed. Dissention among experts as to the seriousness of the problem and how to address also further muddied the waters.

The Fulcrum between Analgesia and Addiction

Though the CDC’s recently released guidelines are as strong as they can currently be, opioid pain treatment regimens – and addiction treatments – continue to be a work in progress. The fractured nature of this field reflects the reason changes were such a long time coming. A multidisciplinary approach will be as essential to working out the kinks as they were to the development of the CDC’s recently released guidelines, as all parties involved strive to save lives and ensure quality of care.

Are you looking for more advanced and comprehensive medical cost containment strategies that protect patient outcomes while also reducing the costs associated with pain management in workers compensation claims? ANS Solutions’ pharmacotherapy review program can help.

This content was originally posted at http://ans-solutions.com/cdc-opioid-guidelines-sheds-light-on-conflicting-expert-opinions/

Key Takeaways from a Recent National Safety Council Survey

Subsequent to the CDC’s new guidelines regarding the treatment of chronic pain, The National Safety Council (NSC) released its latest survey regarding doctor prescribing practices. Summarized below, the statistics:

CDC Guidelines: Use non-opioid therapies first.
NSC Stats: 74% of doctors erroneously believe opioids (morphine, oxycodone) are the most effective way to treat pain.

The Missing Link: Research shows OTC pain meds (ibuprofen, acetaminophen) offer the most effective relief for acute pain.

CDC Guidelines: Do not use opioids for the routine treatment of chronic pain.
NSC Stats: 67% of doctors base there prescribing practices – in part – on patient expectations.

The Missing Link: Patients are often unaware – and doctors wary to inform them – of the effectiveness of alternative treatments for pain. 50% of those patients would return to those prescribers offering alternative treatment.

CDC Guidelines: No longer than 3 days of opioid treatment, beginning with the lowest effective dose.
NSC Stats: 99% of doctors are prescribing these highly addictive drugs for longer than the CDCs recommended time frame – 23% for at least a month.
The Missing Link: Though doctors have the best interests of patients at heart, additional education and training on effective pain management are integral to curbing the rising opioid epidemic.

CDC Guidelines: Address harms of opioid use and assess risk for abuse prior to opioid therapy.
NSC Stats: 84% screen for abuse.
The Missing Link: Only 32% screen for a family history of addiction – a strong indicator.

CDC Guidelines: Re-evaluate risks of continued therapy regularly.
NSC Stats: 99% of doctors have seen a pill-seeking patient – only 32% refer pill-seekers to treatment.
The Missing Link(s): 88% of doctors find referrals overly difficult due to patient unwillingness to cooperate, lack of insurance coverage for such treatments, long wait lists, or lack of providers.

Actionable Treatment Recommendations

ANS's Pharmacotherapy Review Program employs a three staged approach to ensure economically balanced and appropriate treatment options for injured workers. Our legal nurse experts are able to present actionable treatment modification recommendations in a written proposal to treating physicians. Key items of interest covered through the recommendations include:

• Consolidation and coordination of drug therapies between multiple prescribers.
• Consideration of alternate therapies.
• Specification of weaning programs for over-prescribed narcotics.
• Use of generics where applicable.

The end result is a cost effective treatment regimen that simultaneously enhances the quality of care for injured workers. To find out more contact ANS today.

This content was originally posted at http://ans-solutions.com/key-takeaways-from-a-recent-national-safety-council-survey/