A few weeks ago, personalized PMP prescriber reports were distributed, providing a snapshot of your prescribing from Jan. 1 to June 30, 2017. The report was sent to let you know how many patients you have prescribed opioids to and provide a comparison to the prescribing of peers within your specialty. I hope you had the opportunity to review this information and found it helpful. If you have questions or comments related to the contents of the report, please contact our MAPS support team at 517-373-1737 or email BPL-MAPS@Michigan.gov.
According to the CDC's Morbidity and Mortality Weekly Report, doctors began prescribing drugs containing opiates at enormous rates in the late 1990s. After government crackdowns made the drugs harder to get, people addicted to the pills turned to a cheaper and more accessible alternative on the street. Thus, the number of people addicted to, and overdosing from, heroin increased significantly. The number of patients getting opioids is still too high, and doctors are giving their patients prescriptions that last longer.
At Beaumont, pain management is certainly a priority as a clinical service from which physicians can glean best practices. Experts like Chief of Pain Management Services J. Bruce Hillenberg, Ph.D., ABPP, are working on initiatives that will brand Beaumont as a leader in addressing the opioid crisis.
For example, physicians must enhance the scope of practice and confidence of primary care physicians in assessing and treatment planning for patients presenting with chronic pain complaints. In addition, they need to look at the integration of pain clinics with the perioperative pathway to pre-screen opioid tolerant patients prior to elective surgery. Another proposed initiative is the development of an intensive pain rehabilitation program for adolescents and adults that is centrally located in Beaumont and framed on a profitable value-based model to sustainability. Programs like these can decrease opioid use among a high-risk population and improve patient self-management and self-confidence in coping.
Dr. Hillenberg's team is also developing a mock survey to assess each hospital’s readiness for the new Joint Commission standards for pain assessment and management, and creating a model to implement addiction medicine resources and/or referral pathways on each hospital campus.
Anywhere from 40-60 percent of opioids prescribed after surgery go unused. Up to 75 percent of patients prescribed opioids do not keep the medication in a safe location and do not know how to dispose of unused medication. All these facts increase the risk for diversion and non-medical use of opioids. Therefore, sponsored drug-take-initiatives with patient/family education about safe use, protection and return of unused medication will be planned within Beaumont.