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Patient Issues
Call-to-Action Announced to Fight State's Opioid Crisis
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May 17, 2016 - 2:09:48 PM

(HealthNewsDigest.com) - At a kick-off ceremony to fight statewide opioid abuse, David Simons DO of Lancaster described the challenges that can exist for a patient dealing with severe back pain, particularly if the patient is a former heroin user. But, working together with patients, Dr. Simons says alternatives to prescribing opioid pain pills can be found. That was a key message at a news conference at the State Capitol on Tuesdaysponsored by the Pennsylvania Medical Society to announce a statewide patient empowerment initiative and physician call-to-action to address the Keystone State's opioid abuse epidemic. "Today, we are moving Pennsylvania forward on this issue by introducing the ‘Opioids for Pain: Be Smart. Be Safe. Be Sure.' initiative that asks both patients and physicians to play a role in the way we think about opioid use," said Scott Shapiro, MD, president of the Pennsylvania Medical Society.

Empowering Patients to Be Smart, Safe, and Sure As a pain management specialist, Dr. Simons has seen all types of patients trying to find relief from discomfort.  Unbearable chronic lower back pain can be quite challenging. And while opioids come to mind as an option, Dr. Simons believes alternative treatments need to be considered, particularly if the patient has a past history of prescription drug misuse or heroin use. During his professional career, he has treated more than one patient dealing with pain and past opioid misuse. "Every patient is different, and some can be quite challenging," he says. "For at-risk patients, I don't even consider prescribing opioid pills."  For example, Dr. Simons says, after exhausting all conservative treatments, he's tried a relatively new and innovative approach to the treatment of lower back pain called Targeted Drug Therapy (also known as intrathecal pain pump therapy) for one such patient. The patient now has pain under control. According to Dr. Shapiro, Dr. Simons' patient story should become the new norm. "Dr. Simons clearly gave this a lot of thought and worked to be safe and smart about a treatment approach," Dr. Shapiro says.  "Many of the things he and his patient did in this situation should set an example for others to think about as well." Dr. Shapiro says the medical society's ‘Be Smart. Be Safe. Be Sure.' initiative gives patients seven basic questions to ask their doctors before taking a pill for pain.  Those questions include

  1. Is this prescription an opioid?
  2. At what level of pain should I take this prescription?
  3. Do I have to take every pill in the prescription?
  4. Where can I safely dispose of remaining pills?
  5. What can I do to avoid addiction?
  6. What are possible warning signs of dependence or addiction?
  7. What can I do if I believe that I might have developed a dependence on this drug?

"When you look at recent data for Pennsylvania that shows 10,394,466 prescriptions for opioid medications were filled by patients in 2015, you quickly realize that many Pennsylvanians rely on a highly addictive medication to find relief from pain," Dr. Shapiro says.  "For as alarming as that number is, it's actually down from more than 11.3 million two years earlier, but we need to work on lowering it even further by trying alternatives," he says. Dr. Shapiro adds, "With such high use of opioids, it's not hard to guess that we're going to have some problems, particularly when they are misused. As overdose statistics suggests, such misuse can be deadly."  A report from the Drug Enforcement Agency identified 2,497 drug-related Pennsylvania overdose deaths in 2014 including those who used opioid pain pills.

Physician Call-to-Action Directs Docs to Five Action Steps "Pennsylvania is at a tipping point in its effort to address the opioid epidemic that is devastating communities throughout the Keystone State," says David Talenti, MD, chair of PAMED's Board of Trustees. "For many years, the expectation of patients and the standard for physicians was to prescribe an opioid."  "The cart was put before the horse in addressing pain and prescribing opioids," he says. "Prescribing education and training was lacking. We had no access to a prescription drug monitoring system, and patients had few options to dispose of medications that they no longer needed." That's changing, Dr. Talenti says. "All of the tools we've needed are now within our grasp or soon will be," he says. "We are at a pivotal moment in which we can begin to turn the tide of the opioid epidemic." According to Dr. Talenti, there are five action steps that were introduced at the news conference and that physicians should take. They include

  1. Know the prescribing guidelines.
  2. Use the ABC-MAP Database once it is up and running.
  3. Refer patients who have a substance use disorder to treatment.
  4. Discuss options to opioids with patients.
  5. Ask patients to keep their pills safe. When they no longer need a prescribed medication, properly dispose of the medication.

Opioids for pain: Be Smart. Be Safe. Be Sure. Dr. Shapiro says PAMED's latest initiative on prescription drug misuse is part of the organization's ongoing plan to address medication safety. In the past, his organization has created public awareness activities to address teen misuse, prescription drug monitoring, and appropriate prescribing. "Medication misuse - whether intentional or not - must be a priority of physicians for the safety of their patients," he says.  "Whether it's grandma taking the wrong pill at the wrong time or a doctor shopper who has an addiction, misuse can have the same devastating impact on a family," Dr Shapiro says. "That's why in the past, PAMED takes mediation safety seriously, and are kicking off our ‘Opioids for pain: Be Smart. Be Safe. Be Sure.' initiative." PAMED's program will empower patients through physician offices as well as health and senior fairs sponsored by state legislators.  Each legislator in Harrisburg was sent a kit complete with posters and handouts. Social media as well as digital advertising also plays a role in raising the profile of being smart, safe, and sure when using opioids for pain. For physicians, in addition to the call-to-action, PAMED has created a web-based center for the initiative at www.pamedsoc.org/opioidinfo, where materials can be downloaded. In addition, prescribing guidelines and continuing medical education are available atwww.pamedsoc.org/opioidresources. Copies of the "Opioids for pain: Be Smart. Be Safe. Be Sure." logo can be downloaded atwww.pamedsoc.org/opioidinfo.

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