A Healthesystems publication

Fall 2015

Raising the Bar to Lower Opioid Risk

While progress is being made to reduce opioid prescribing, institutions and groups are doubling down on efforts to lower the risk of opioid misuse, including more stringent guidelines.

 The last couple of years have seen a decline in the number of opioids being prescribed, but evidence still shows that a significant portion of patients are receiving chronic treatment with opioids longer than 90 days. According to a recent study conducted in Rochester, New York, 1 in 4 patients receiving a new opioid prescription progressed to chronic use.1 Further, patients receiving long-term opioid treatment were more likely to have a past or current history of substance abuse, even though treatment guidelines specifically recommend that these patients should not receive opioid therapy. And while prescribing habits and rates vary by state, it remains that millions of Americans are receiving long-term opioid treatment.  

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1 -Hooten WM, St Sauver JL, McGree ME, et al. Incidence and risk factors for progression from short-term to episodic or long-term opioid prescribing: a population-based study. Mayo Clin Proc. 2015;90:850-6.
2 -Zedler B, Xie L, Wang L, et al. Risk factors for serious prescription opioid-related toxicity or overdose among Veterans Health Administration patients. Pain Med. 2014;15:1911-29.
3 -Hegmann KT, Weiss MS, Bowden K, et al. ACOEM Practice Guidelines: Opioids for treatment of acute, subacute, chronic, and postoperative pain. J Occup Environ Med. 2014;56:e143-e159.
4 -Bohnert AS, Valenstein M, Bair MJ, et al. Association between opioid prescribing patterns and opioid overdose-related deaths. JAMA. 2011;305:1315-21.
5 -Dunn KM, Saunders KW, Rutter CM, et al. Opioid prescriptions for chronic pain and overdose: a cohort study. Ann Intern Med. 2010;152:85-92.
6 -Healthesystems data.
7 -Washington State Agency Medical Directors’ Group (AMDG). Interagency Guideline on Prescribing Opioids for Pain, 3rd Edition. June 2015.
8 -California Division of Workers’ Compensation (DWC). Draft Medical Treatment Utilization Schedule (MTUS) Chronic Pain Medical Treatment Guidelines and Opioids Treatment Guidelines. July 2015. http://www.dir.ca.gov/dwc/DWCPropRegs/MTUS-Opioids-ChronicPain/MTUS-Opioids-ChronicPain.htm
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