Reducing Opioid Risks Through Management and Alternatives
While employers are making progress in their efforts to end America’s opioid epidemic, the death toll is still rising due to other factors. Using opioids for management of pain during recovery from injuries is a high-risk practice, and replacing opioids with alternatives is a best practice that is slowly taking hold, in the face of many challenges.
Reform in Progress
A national campaign against opioid mismanagement is beginning to reduce the number of new prescriptions for opioids. If management strategies are also applied to monitor, adjust, and end existing opioid use appropriately during treatment, opioid addiction risks can be reduced.1 These practices also can reduce the number of cases of hyperalgesia, where extended opioid use results in higher pain sensitivity and reduced function. All of this is great news for people seeking treatment for painful injuries or illnesses, and for their employers.
Most states have updated guidelines around prescribing opioids, including their use in managing chronic pain. The Centers for Disease Control (CDC) has also published guidelines,2 notes Michael Coupland, CPsych, CRC, developer of the COPE with Pain program. Guidelines often include risk mitigation strategies such as only one provider prescribing opioids to a patient, urine drug screening during treatment, and behavioral support for patients with aberrant behavior.
Reforms still in process involve physician training on the guidelines which will help prescribing practice become more uniform, reduce error, and provide patients with more supervision and support while opioids are part of the treatment program. The first medical specialties targeted for training were on the front line of the opioid epidemic: pain specialists, occupational physicians, and orthopedists. Training may be slower to reach physicians in some other fields, such as primary care physicians or family doctors.
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