OPIOID ABUSE, CONT. Southern Oregon aiming to encourage the appropriate and safe treatment of chronic pain. The group created guidelines for safe prescribing and established a website for professionals and the public. In addition, Jackson County partners with local coordinated care organizations and other health care groups to create innovative strategies to reduce inappropriate opioid prescribing. These include educational workshops, provider outreach and new treatment programs. Their efforts are showing results: In 2014, Jackson County recorded its lowest prescription drug overdose rate in a dozen years. In 2015, the Oregon Coalition for Responsible Use of Meds received $420,600 from the Oregon Department of Justice as part of a settlement the state reached with a prescription opiate manufacturer. With that money, the coalition has set four main objectives to reduce opioid misuse and abuse effectively: Œ Reduce the number of pills in circulation through better prescribing practices, including improved access to non-opioid alternatives and non-drug pain management. Œ Make disposal easier for expired, unwanted or unused prescription drugs. Œ Improve access to substance-abuse treatment and to the drug Naloxone. Naloxone has saved many lives since a 2013 statute allowed trained laypeople to administer the drug. Œ Educate patients, families and providers to improve care and reduce dependence on opioids. Public health officials in the Portland tri-county area and Jackson County plan to align with the coalition to build a statewide public education campaign based on Shames’ Southern Oregon Pain Guidance group. Efforts will include regional resource pages to help providers, patients and family members make the best choices about pain management. In December, a large coalition of health care professionals and health systems in the four-county Portland metropolitan area released guidelines to reduce opioid prescriptions and their associated problems. The announcement came on the heels of a report showing that in 2014, for the first time, the number of deaths from prescription drugs equaled the number of deaths from heroin overdoses. The guidelines include an education campaign Oregonians are prescribed more than 100 million opioid pills every year, double the amount since 2000. for doctors and the public, using posters, billboards and a website. It also calls for increased availability of Naloxone. Paul Lewis, MD, MPH, health officer for Multnomah, Washington and Clackamas counties, noted that by having local hospital systems follow the new prescription guidelines, patients will be less likely to shop around for a physician to prescribe opiates. Robert Dannenhoffer, MD, health officer for Douglas County, said the state’s PDMP database has helped in that regard. “I think already we are starting to see some changes,” he said. “Doctors are much more cautious. Overall, we’re starting to see some light, but there are still a lot of people hooked. What’s more, the street cost of prescription opiates is expensive compared with heroin, and many addicts have switched to heroin,” he said. An additional initiative is the Eastern Oregon Pain Guidance group. Clinicians in Eastern Oregon are launching a work group to develop community prescribing guidelines and decision aids to help reduce the flow of opioids. Betsy Neeley, MD, La Grande and Elizabeth Powers, MD, Enterprise, along with the Eastern Oregon 12 Medicine in Oregon www.TheOMA.org
OMA Medicine in OR Winter 2015 2016
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