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Utah Finalizes Guidelines For Prescribing Pain Meds

Ruzanna Harutyunyan's picture

The Utah Department of Health (UDOH) released its final draft of clinical guidelines to assist health care providers in safely prescribing pain medications. UDOH developed the guidelines in partnership with two multi-disciplinary panels of physicians as part of an ongoing campaign to reduce the amount of prescription drug overdose deaths. In 2007, the most recent year for which data is available, more Utahns (317) died as a result of prescription pain medication overdoses than died in car crashes.

The guidelines contain a number of recommendations providers may use in their practices to aid in the safe distribution and use of prescription pain meds. Some key recommendations include:

• Alternatives to opioid treatment should be tried before initiating opioid treatment;

• Providers should screen for risk of abuse or addiction before initiating opioid treatment;

• Methadone should only be prescribed by clinicians who are familiar with its risks and appropriate uses, and who are prepared to conduct the necessary, careful monitoring of patients;

• Long-acting opioids should usually not be used to treat acute pain;

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• Methadone should rarely, if ever, be used to treat acute pain;

• The patient should be informed of the risks and benefits of opioid treatment.

The guidelines also include more than 20 tools for providers to use in their practice which will help them implement the recommendations. Included are tools for monitoring patients on opioids, tools to screen for risk of opioid-related abnormal behaviors, sample treatment plans, dosing guidelines and other information.

“It’s important for physicians and the public to be aware that these guidelines are recommendations, they are not requirements and they are not laws,” said UDOH Executive Director Dr. David Sundwall. “However, it’s also important to recognize prescription pain medication overdose deaths have reached epidemic proportions in Utah and health care providers bear some responsibility in combating the problem.”

Utah becomes just the second state in the nation to develop guidelines for healthcare professionals to follow when prescribing pain medications for treatment of chronic and acute pain. Prescribing of opioid medications has substantially increased over the past 10-15 years; medications such as hydrocodone, oxycodone, and methadone increased 6-fold from 1997-2002 in Utah.

“Prescription pain medications are an important tool for treating patients with pain,” said UDOH State Epidemiologist Dr. Robert Rolfs. “Our hope is that these guidelines will help physicians better manage their patients’ pain while avoiding some of the potentially very serious risks of these medications.”

Last year, UDOH launched the Use Only as Directed campaign to educate Utahns about the dangers of prescription drug misuse. The goal is to reduce the number of unintentional prescription pain medication overdoses in Utah by 15 percent this year.