At AffirmHealth, our work focuses around working with clinicians to ensure that they are prescribing opioids in a reliable and compliant manner that gives administrators insight into what is happening across their organizations. From the clinician’s viewpoint, my job is to help ensure that the clinical information and the decision support we implement works in a way that actually improves care delivery to the patient—after all, if our work isn’t actually making care better, then we’re doing a disservice to the patient. While our blog has covered a wide range of critical issues around these topics, one thing we’ve never actually discussed is how clinicians should approach the topic of opioid abuse with their patients, strategies for successful risk screening, and what to do if one of your patients develops an opioid use disorder.
In November of 2018, the DEA released the results of the 2018 National Drug Threat Assessment. The 164 page report highlighted the threats posed to the United States by domestic and international drug trafficking and the abuse of illicit drugs. The DEA’s acting administrator, Uttam Dhillon, said the assessment “underscores the magnitude of the nation’s opioid crisis and highlights the necessity of using all the tools at our disposal to fight this epidemic.”1
The Opioid Epidemic in America is a topic covered extensively, each and every day in the news. AffirmHealth covers this topically frequently as well, most recently in our, "Where are We Now?" article.
Historically, research has shown that nearly 1 in 4 high school seniors in the United States have been exposed to prescription opioids through either medical or non-medical use. On November 12, 2018 a JAMA abstract reported: Between 1997 and 2012, the rate of hospitalization due to opioid poisonings nearly doubled in US children and adolescents. Opioid use early in life is associated with a higher likelihood of opioid misuse in the future.
For those of us involved in the opioid epidemic as caregivers, patient advocates, and researchers, there was an interesting moment earlier this year when a series of news stories noted some optimism in the fight against overdose deaths.
In mid-October, Health and Human Services Secretary Alex Azar commented on preliminary data from the U.S. Centers for Disease Control and Prevention that suggested “that the U.S. may be ‘beginning to turn the tide’ on the opioid crisis.” “The seemingly relentless trend of rising overdose deaths seems to be finally bending in the right direction…We are so far from the end of the epidemic, but we are perhaps at the end of the beginning.”
As the opioid misuse and overdose epidemic impacts communities across America and has sweeping global implications, practitioners are looking to the future of pain management and the novel treatment options that may be on the horizon.
Earlier this month on November 2nd, the U.S. Food and Drug Administration approved Dsuvia, a new sublingual version of an older drug, sufentanil, that has been in use since 1984.
Last week on the AffirmHealth Blog we discussed MIPS and PDMP Usage and promised a follow up on additional Improvement Activities. So this week we look at an Improvement Activities Data overview as well as a handful of activities potentially pertinent to providers prescribing opioids or other controlled substances.
Let’s start at the beginning…
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