Chronic pain physicians had them. So did emergency room doctors. Now outpatient physicians have clear guidelines for managing acute pain without quickly resorting to opioids.
The Indiana Hospital Association, Indiana State Medical Association and the Indiana State Department of Health collaborated to produce the guidelines that aim to discourage the overuse of prescription pain pills considered responsible for driving the opioid crisis.
“I believe these guidelines are a critical tool for both healthcare providers and for patients and will allow them to work together to identify the safest and most effective tools to treat their acute pain,” said Dr. Kristina Box, Indiana State Health Commissioner.
The new guidelines recommend that for patients with acute pain — pain defined as being related to damaged tissue and that will resolve with healing in a matter of days and weeks — doctors first consider non-pharmacologic treatment, such as ice, acupuncture, chiropracty and massage. If those are not strong enough, doctors should then consider non-opioid pharmacologic treatment, the guidelines say.
Only the most severe injuries warrant opioids, the guidelines say. In those instances, doctors should take several steps to ensure that the drugs are not misused, using opioids only in concert with other therapies, putting patients on the lowest dose possible and offering no refills.
An Indiana law that went into effect in July prohibits doctors from prescribing more than a seven-day supply to patients under 18 or to adults for whom that is their first prescription from that provider. Within the first few months of the law going into effect, there were 100,000 fewer prescriptions written, said Dr. John McGoff, president of the Indiana State Medical Association.
The stunning statistics associated with the opioid epidemic prompted the experts to devise ways to decrease doctors’ reliance on opioids. Excessive prescribing in the early part of this century helped stoke the epidemic, many experts believe.
Since 1999, Indiana has seen death by drug overdose increase by 500 percent.
Nationally accidents have become the third leading cause of death in the United States for the first time ever, according to the National Safety Council.
In 2016, preventable deaths increased by 10 percent over the previous year, largely due to a rise in deaths due to drug overdoses and motor vehicle crashes. Previously chronic respiratory diseases were responsible for the most deaths after heart disease and cancer, according to the Centers for Disease Control and Prevention.
While the experts who wrote the guidelines hope doctors find them useful, the final decision of whether to prescribe an opioid still rests with the doctor, said Julie Reed, executive vice president of the Indiana State Medical Association of the guidelines. Doctors will be able to tailor their decisions to fit their patients’ needs.
“They don’t stand to replace professional judgment or clinical judgment,” said Julie Reed, executive vice president of the Indiana State Medical Association of the guidelines. “That’s really an important thing that needs to be balanced, that is to make sure that the needs and unique characteristics and judgment that healthcare providers have learned through their training over the years can really serve to complement these guidelines.”
IndyStar’s “State of Addiction: Confronting Indiana’s Opioid Crisis” series is made possible through the support of the Richard M. Fairbanks Foundation, a nonprofit foundation working to advance the vitality of Indianapolis and the well-being of its people.
Call IndyStar staff reporter Shari Rudavsky at (317) 444-6354. Follow her on Twitter and on Facebook.
Filed under: General Problems
With over 400,000.00 medical errors a year,,,my body endured several of them,,,,,WHAT A BUNCH OF SIC,,IDIOTIC,,,,IDIOTS,,,,TYLENOL,,, really,,,after back surgery,heart surgery,,hell any surgery,,This is what kolodyns,,shatterproof,,,blucross,cigna,,atena,,,,false data has done,,,what their corruption in our government has done,,,,and what our government has allowed to happen in America,,,
Die 1st before Ill give u effective pain relief,,,,have a hearattack 1st,,,from untreated physical pain,,,,then,,,ill give u the needed opiatemedicine,,,,,,how ass backwards have we allowed the field of medicine to become??Sorry,,,this is what happens when good people do nothing!!!!maryw
I’m with you. If dress don’t know who is pill shopping and those with a legitimate who don’t abuse their meds then those who have a sincere reason for taking them are going to get screwed. That is why people who are abruptly taken off their meds turn to the street to get relief.