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How Not to Combat the Opioid Epidemic

June 9, 2017

Short Attention Span Summary

Are statewide mandates the way to go?
A statewide measure to mandate “best practices” for opiate prescribing in Washington reduced ED prescriptions by 1.5%.  This was a very small change.  Far better are local, departmental efforts, with buy in from the affected providers, as in the study covered earlier this month which had a 10% reduction in opiate prescriptions.  The mandates are paraphrased here.

  1. Sharing of patient visits to other EDs
  2. Patient education to use the ED only for emergencies
  3. Lists of frequent flyers
  4. Help for frequent flyers
  5. “Strict” narcotic prescribing guidelines.
  6. Enrollment in the narcs database
  7. Review of ED utilization feedback reports

Spoon Feed
Statewide, non-specific mandates may help a little.  Local and departmental policy change, with provider buy-in, is even better.

Impact of Hospital “Best Practice” Mandates on Prescription Opioid Dispensing after an Emergency Department Visit.  Acad Emerg Med. 2017 May 23. doi: 10.1111/acem.13230. [Epub ahead of print]

Written by Clay Smith.  Reviewed by Thomas Davis.

What are your thoughts?