• July 15, 2019

Awareness drives down opioid prescriptions

The use and misuse of synthetic opioids has dominated national and political conversations for the last several years. Touted as an important game-changer for managing pain when they were introduced in the mid-1990s, synthetic opioids today are the face of a dreadful national crisis featuring stories of tragic addiction, overdose and upheaval in communities around the country. 

Several reports and educational efforts show the crisis has galvanized healthcare professionals who now are encouraging alternatives and are resisting routine opioid use for their patients. Organized dentistry has stepped up with a campaign to discourage opioid use through a better understanding of prescribing methods and history as well as pain control. 

A webinar, organized by the Centers for Disease Control and Prevention and the American Dental Association, will explore the opioid crisis with recommendations on pain management and opioid prescriptions. The webinar will be held Wednesday, July 17, to review best practices and suggest patient conversations about pain control. (To register, click here.)

Conversations work, as was underscored in a new study of 190 surgery patients at the University of Michigan Medical School. 

Published in the Journal of American College of Surgeons this year, the study took aim at opioids, calling them “overprescribed” for surgical procedures, “leading to dependence and diversion into the community.”

Rather than using opioids as a “go-to” after surgery, the study developed a new protocol to teach patients how to manage their pain with acetaminophen and ibuprofen without the use of any or few opioid pills. The study’s co-author, Dr. Chad Brummett, said the success of the protocol centered on setting expectations and educating patients about pain medications and pain management.

Overall, synthetic opioid prescriptions are falling – a 33% drop nationally from 2013 to 2018 -- as the crippling addictive effects of the drug are better understood.

In Illinois and Indiana, opioid prescriptions fell by more than a third between 2013 and 2018, according to an opioid task force of the American Medical Association. Illinois fell by 34.5% while Indiana dropped 35.1%. 

Physician Danesh Alam, medical director at Central DuPage Hospital in Wheaton, is an active researcher into addictive disorders. He supports “medication-assisted treatment” for patients battling an opioid addiction, using three different drugs to wean them off an opioid.

“Primary treatment alone is not a measure of success,” he said. “Long-term treatment and engagement are critical,” noting that not enough attention is focused on the help and treatment patients need to beat their opioid addiction.

Illinois’ Prescription Monitoring Program is a statewide database that helps registered healthcare professionals track patient prescriptions in an effort to combat “opioid shoppers” and street sales. The program shows patient prescription records over the last 12 months and keeps records for two years. It is free, self-reporting and voluntary, and results are available 24 hours a day.

Indiana’s prescription drop is “not surprising at all," Dr. Shaun Kondamuri, a Munster, Ind., pain management specialist told the Northwest Indiana Times. "The state of Indiana has been very proactive in trying to reduce the number of prescriptions that are written."

In 2017, the Indiana state legislature passed a law limiting first-time opioid prescriptions to seven days. "It's been very much in the front of our mind for doctors," he said.