State takes stab at opioid crisis, tells doctors to prescribe less

(file: KATU)

The Oregon Health Authority issued new prescribing deadlines for opioids aimed at tackling the opioid crisis.

Officials say the new guidelines are for acute pain management in people that currently do not use opioids. Katrina Hedberg, M.D., Oregon’s state health officer, says their goal is patient safety.

“The idea is to have them be on as short as possible, and low dose as possible, so they don’t' become dependent on opioids over the long period,” said Hedberg.

Under the new guideline, doctors may try over the county pain killers or other treatment methods. If you are prescribed opioids, doctors will limit the dose to the “lowest effective dose of short-acting opioids for no more than three days in most cases and no more than seven days in cases of more severe acute pain.”

Hedberg says the default for prescribing pain killers had been 30 days. These new guidelines, she says, would keep patients have having dozens of leftover pain pills.

Under the new guidelines, doctors will check patient history to see if they have a history of long-term opioid use or substance use disorder. They will also check Prescription Drug Monitoring Program, which tracks prescribed controlled substances.

Five people died every week in Oregon from an opioid-related overdose, according to OHA. Last year, more than 72,000 people died of a drug overdose nationwide.

“I see these recommendations from the Oregon Health Authority as an excellent move in the direction of preventing the possibility of people becoming addicted,” said Andy Mendenhall, M.D., Senior Medical Director for Substance Use Disorder Services with Central City Concern.

Mendenhall says they see thousands of patients a year with substance use problems and about half of them are addicted or dependent on opioids.

“Many of our patients report first started taking these pills either through a prescription they received, or through grandmas medicine cabinet, or their mother or father's medicine cabinet,” he said.

Back pain is one of the most common reason someone goes to a physician in the United States. It’s also the leading reason someone is prescribed opioids, according to Roger Chou, M.D., a medical professor at OHSU.

“I would say [the opioid crisis] is probably our number one public health issue at this time,” said Chou.

Keeping in line with the OHA guidelines, Oregon Health and Science University doctors are now treating acute back pain differently. Chou helped create the new back pain guidelines at the hospital.

Instead of going straight to pain killers, Chou says doctors are recommending patients stay active.

“We know there are quite a few non-drug treatments, like exercise therapy, like yoga, like spinal manipulation, like acupuncture, that can actually help relieve pain when people have low back pain. Medication may not be necessary at all,” he said.

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