New opioid prescribing recommendations designed to guide hospital-based physicians’ use have been adopted and released by a coalition of health care policy and advocacy organizations.
The revised guidance reflects evolving best practices in the use of opioids for pain management and changes in the law designed to reduce the opioid addiction crisis.
In November 2015, the Missouri Academy of Family Physicians, Missouri Association of Osteopathic Physicians and Surgeons, Missouri College of Emergency Physicians, Missouri Dental Association, Missouri Hospital Association, and Missouri State Medical Association jointly recommended a set of hospital emergency department guidelines to reduce variation in opioid prescribing practices.
This new recommended guideline expands the recommendations and reflects developments in best practices.
“The guidelines serve to assist physicians in following best opioid prescribing practices while still allowing for individual autonomy and judgment,” said Evan Schwarz, M.D., MOCEP president and assistant professor of emergency medicine at Washington University School of Medicine in St. Louis.
Hospitals are on the front line of the opioid crisis. These recommendations provide guidance for all hospital-based physicians, rather than just emergency physicians, that are consistent with guidance from the Centers for Disease Control and Prevention and update prescribing limits for first-time acute pain management to synchronize with Missouri’s new law.
“Opioid abuse prevention is the primary goal,” said Leslie Porth, R.N., Ph.D., MHA senior vice president of Strategic Quality Initiatives. “When providers have the knowledge and tools to make informed decisions about patients’ pain management options, patients get better, safer care.”
The guidance includes a new recommendation encouraging physicians to consider prescribing naloxone upon discharge to patients at risk of overdose. Naloxone, an overdose rescue medication, can be used by patients or bystanders to reverse an opioid overdose.
“Missouri’s family physicians continue to implement evidence-based strategies that both prevent opioid misuse and reduce harm associated with opioid use,” said Sarah Cole, D.O., fellow of the American Academy of Family Physicians and MAFP president. “These recommendations are clear and succinct for all physicians who care for people in the emergency department and hospital settings.”
The recommendations are being implemented this month.