Re­duce health care sys­tem’s de­pen­dence on dan­ger­ous opi­oids

The Palm Beach Post - - OPINION: THE DEBATE STARTS HERE - WE­STON Edi­tor’s note: Os­mel Del­gado is chief op­er­at­ing of­fi­cer with Cleve­land Clinic Florida.

There is good news to re­port in the bat­tle to fight the opi­oid epi­demic, and it’s com­ing from the peo­ple whose job it is to treat pain. We’re see­ing the be­gin­nings of a na­tional, strate­gic ap­proach from health care providers to re­think how pain is treated, sup­ported by promis­ing re­gional and lo­cal ini­tia­tives.

There isn’t a mo­ment to waste. The lat­est an­nual Na­tional Sur­vey on Drug Use and Health (NSDUH) es­ti­mates that 11.5 mil­lion peo­ple over the age of 12 mis­used pre­scrip­tion pain re­liev­ers in 2016. States such as Florida and Ohio are among the hard­est-hit ar­eas. In Florida, deaths last year at­trib­uted to opi­oid abuse were up ap­prox­i­mately 37 per­cent from 2015. Palm Beach and Broward coun­ties lead the state in drug over­dose deaths.

Ohio’s gov­er­nor made news re­cently by es­tab­lish­ing acute pain pre­scrib­ing lim­its. The lim­its al­low health pro­fes­sion­als to pre­scribe painkillers for acute pain only up to seven days for adults and five days for kids and teens, with sev­eral ex­cep­tions. Florida’s gov­er­nor has pro­posed even more re­stric­tive mea­sures.

At the na­tional level, the Joint Com­mis­sion, which ac­cred­its and cer­ti­fies nearly 21,000 U.S. health care or­ga­ni­za­tions and pro­grams, re­leased new pain as­sess­ment and man­age­ment stan­dards for ac­cred­ited hos­pi­tals that will take ef­fect Jan. 1. Th­ese stan­dards re­quire hos­pi­tals to of­fer al­ter­na­tive pain treat­ment meth­ods, such as acupunc­ture, chi­ro­prac­tic, phys­i­cal and cog­ni­tive be­hav­ioral ther­a­pies. Ear­lier this year, the U.S. Cen­ters for Dis­ease Con­trol and Preven­tion weighed in, is­su­ing new clin­i­cal prac­tice guide­lines on the ap­pro­pri­ate use of opi­oid ther­apy for pain man­age­ment.

Th­ese na­tional ef­forts will no doubt fuel fur­ther adop­tion of re­gional and lo­cal pain man­age­ment strate­gies.

Us­ing non­ad­dic­tive painkilling tech­niques for in­jury and post-sur­gi­cal pain man­age­ment is another ap­proach. In one clin­i­cal trial, Cleve­land Clinic Florida or­tho­pe­dic sur­geons are com­par­ing ul­tra­sound-guided in­jec­tions of anal­ge­sia to spe­cific nerves ver­sus a slow-re­lease pain pump ap­proach.

Ul­ti­mately, chang­ing pre­scriber habits is vi­tal for pa­tient safety. Work­ing to­gether at the na­tional and lo­cal level, we are poised to make a real dif­fer­ence in fight­ing this in­sid­i­ous epi­demic.


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