Opioid Prescribing Recommendations Endorsed By Six Health Care Provider Organizations

December 1, 2015

Six organizations representing Missouri health care providers today issued recommendations to their collective memberships on an initial step to reduce opioid painkiller misuse and abuse. The Missouri Academy of Family Physicians, Missouri Association of Osteopathic Physicians and Surgeons, Missouri College of Emergency Physicians, Missouri Dental Association, Missouri Hospital Association and Missouri State Medical Association jointly recommended that health care providers adopt a core set of actions to reduce variation in opioid-prescribing practices.

State-specific research released earlier this year found that hospital treatment for commonly-prescribed opioid painkillers — where overuse is a primary or contributing factor for inpatient or emergency care — increased 137 percent in Missouri between 2005 and 2015. Additionally, separate research suggests a strong link in opioid abuse and heroin addiction, and submits as many as three out of four prescription opioid abusers will eventually use heroin as a less expensive source of opioids. This inappropriate use of controlled substances is having a major negative impact on the lives of many Missourians and the communities where they live.

“Missouri doesn’t have a comprehensive policy to address opioid misuse and abuse,” said Christopher D. Howard, President of Hospital Operations at SSM Health in St. Louis, and Missouri Hospital Association Board Chair. “There are limited options available to identify inappropriate use of these necessary but powerful painkillers. As leaders in health care delivery, we’ve joined together to identify and deliver best practices for use by caregivers on the frontlines of the health care delivery system.”

Many of the state’s emergency departments have existing systems to reduce the incidence and risk of opioid misuse and abuse among patients. However, there has not been a consistent set of guidelines statewide for providers throughout the state. The ten newly recommended actions can be adopted as a stand-alone policy, or in addition to existing successful strategies.

The policy recognizes the importance of medical staff decision-making and clinical judgement at the patient level, while providing a framework for informed decisions.

“Health care providers have a responsibility to their patients and communities to lead in efforts to reduce opioid misuse and abuse,” said Evan Schwarz, M.D., FACEP. “Emergency physicians deal with opioid misuse and abuse on a daily basis, and we welcome efforts to address this by clarifying patient expectations and the roll of the ED in managing their pain. This is an important initial effort to address the problem of prescription drug abuse. However, in the long run, it will require a multi-disciplinary, public-private approach to provide treatment, reduce abuse and its costs.”