Pharmacy Times reports that, "The first PDMP program was enacted by New York State in 1918 and was used to monitor prescriptions for cocaine, codeine, heroin, morphine, and opium. With this program, pharmacists were required to report copies of prescriptions to the health department within 24 hours."
We’ve previously written about the challenges clinicians and patients face as they seek non-opioid alternatives for effective pain management. One such alternative, Mitragyna speciose, or kratom, has been a focus of increased public discussion lately, but is still a topic that many clinicians are unfamiliar with. AffirmHealth has developed this short primer to help bring you up to speed so that you can have an informed discussion with your patients.
When we first founded AffirmHealth in April 2016, we had one goal: to make opioid prescribing safer for patients and providers. We did that by automating state opioid database queries so that they integrated with clinicians’ workflow and improved patient safety, maximized provider efficiency, and fixed a headache for both patients and providers. In 2018, we are going to be dramatically expanding that offering and I wanted to spend some time explaining our value proposition and how we support practices that use our services. Our focus is still the same: we recognize that opioids have a critical role in the management of pain. But even one overdose is too many. Our goal is to make sure we help drive that number to zero.
This past week, several of our nation’s public health experts testified on Capitol Hill before the Senate Health, Education, Labor, and Pensions Committee. They made the concerning argument that despite all of the effort and attention being cast on the national opioid epidemic, we are failing to make significant progress. In fact, we are continuing to lose ground and opioid related deaths continue to accelerate across the country.
With all of the recent attention cast on the national opioid epidemic and the increase in overdose deaths, one issue that seems to have fallen out of focus is the need for increased scrutiny on concomitant drug prescriptions, particularly benzodiazepines. The combination of opioids and benzodiazepines was found to be dangerous enough that dual prescribing of the two medications caused the FDA to issue black box warnings when prescribing each of these medications in 2016. An article originally published in Clinical Advisor (March 2017) makes two important points:
At AffirmHealth, we're passionate about improving the processes needed to manage chronic pain safely. In the past, I've written several times about the patient-physician relationship and the complex parts of managing those relationships in the setting of our national opioid epidemic. This morning, CNN published an interesting article that highlights another side of the problem: the increasing legal issues that physicians are facing as they navigate the pain management landscape. I share it here not so much to give a direct opinion on the issue, but because I feel that it's important that we all engage in a discussion informed by everyone's viewpoint. This article goes a long way to sharing the evolving physician and law enforcement perspective. The following is directly reprinted from CNN:
After reviewing several articles regarding the controversy chronic pain patients are facing due to physicians changing policy in fear of the CDC Opioid Guidelines, I feel it necessary to address the seriousness of turning away legitimate chronic pain patients seeking medical care, because of the perceived stigma attached to opiates.
First, Let's Talk About My Pain.
Pain can be explained as either chronic or acute. Acute pain is described as pain that has just occurred after an injury such as surgery or trauma to our body. Acute pain will improve over time as our bodies heal from this injury or surgery.
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