Weekend RoundUp

Ketamine Guidelines, Kentucky Sues Walgreens, SAMSHA Updates Opioid Toolkit and more

With opioid prescribing regulations being updated, national policy announcements, state guidelines as well as daily commentary regarding the opioid epidemic flooding news outlets, the AffirmHealth Weekend Round Up looks at the top headlines that caught our team’s eye. From controlled substance protocols to research focusing on pain management, addiction medicine, the ER and more provided to you in an easy to access summary. News you can use. Welcome to the Weekend Round Up.


NATIONAL NEWS: Opioid Epidemic

June 11, 2018

SAMSHA Publishes Updated Toolkit to Help Prevent Opioid Overdoses

Source: samsha.gov

AffirmHealth Key Take Away:

The Substance Abuse and Mental Health Services Administration (SAMHSA) has published an update to its Opioid Overdose Prevention Toolkit.

Specifically, the toolkit presents five strategies:

1. Encourage health care providers, people at high risk for overdose, family members and others to learn how to prevent and manage opioid overdose.

2. Ensure access to treatment for people who are misusing opioids or who have a substance use disorder.

3. Ensure ready access to naloxone.

4. Encourage people to call 911 in the event of a possible overdose.

5. Encourage health care providers to use prescription drug monitoring programs to prevent overprescribing of opioids.

Find the Full Press Release Here: SAMSHA Press Announcement



June 7, 2018

Consensus Guidelines on the Use of Intravenous Ketamine Infusions for Chronic Pain From the American Society of Regional Anesthesia and Pain Medicine, The American Academy of pain Medicine and the American Society of Anesthesiologists

Source: Regional Anesthesia & Pain Medicine

AffirmHealth Key Take Away:

Guidelines published this week in Regional Anesthesia and Pain Medicine respond to calls for clarity from healthcare providers, payers, patients and their advocacy groups, and healthcare administrators regarding the use of ketamine in the chronic pain clinic setting.  Since the use of ketamine to treat chronic pain has not undergone the rigorous testing required by regulatory bodies for approved indications, the literature is characterized by small and methodologically flawed studies, note the authors of the guidelines. This makes the creation of guidelines challenging, but more imperative.  The guidelines contain recommendations on a variety of issues confronting clinicians including indications, monitoring requirements, dosing regimens, contraindications and recommended pre-infusion tests, and what constitutes a positive response.

Simultaneously published are guidelines for the use of IV ketamine for acute pain. These guidelines recommend that sub-anesthetic ketamine infusions “be considered for patients undergoing large painful procedures, patients who are opioid-dependent, opioid-tolerant patients with chronic pain that have an acute exacerbation, and patients at risk of side effects from high doses of opioids such as patients with obstructive sleep apnea,” writes James P. Rathmell, MD, professor of anesthesia at Harvard Medical School and Chair of the Department of Anesthesiology, Perioperative and Pain Medicine at Brigham and Women’s Health Care in Boston, MA, in an editorial accompanying the guidelines.

Both guidelines have been approved by the American Society of Regional Anesthesia and Pain Medicine, the American Academy of Pain Medicine, and the American Society of Anesthesiologists.

Find the Full Press Release Here: New Ketamine Guidelines for Pain Released

Find the Full Abstract Here: Consensus Guidelines on the Use of Ketamine Infusions for Chronic Pain


STATE NEWS: Kentucky

June 15, 2018

Kentucky Sues Walgreens Over Opioid Epidemic

Source: cbsnews.com

AffirmHealth Key Take Away:

The state of Kentucky is suing Walgreens Boots Alliance, saying the drugstore chain failed to monitor its own operations that shipped and dispensed large quantities of opioids throughout the state.

The lawsuit filed Thursday by Kentucky Attorney General Andy Beshear alleges Walgreens engaged in unfair, misleading and deceptive business practices by filling huge opioid orders with great frequency, while failing to report suspicious orders to authorities.

In its dual role as distributor and pharmacy, Walgreens' actions "flooded Kentucky communities with dangerous prescription drugs, directly contributing to the state's drug epidemic," Beshear's office said in a news release

Find the full article here: Kentucky Sues Walgreens Over Opioid Epidemic


NATIONAL NEWS: Opioid Epidemic

June 14, 2018

Crackdown on Prescription Opioids Followed By Increase in “Dark Web” Purchases, Study Finds

Source: The Independent

AffirmHealth Key Take Away: Illicit online opioid purchases surged after the government cracked down on prescription painkillers, a new study has found.

With the United States grappling with a metastasising opioid addiction crisis, the US Drug Enforcement Agency (DEA) in 2014 tightened restrictions around drugs containing hydrocodone. The change made it more difficult to obtain and refill prescriptions for the widely user painkiller.

Many of the people who have become addicted to opioids in recent years have first developed a dependency on the drugs after being legally prescribed painkillers. Law enforcement officials were seeking to dam that outlet to addiction.

But in seeking to cut off access to opioids, the DEA instead pushed users into the online black market, a study published in medical journal the BMJ suggests.

Find the Full Article Here: Crackdown on Prescription Drugs Followed by Increase in Dark Web Purchases


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