Opioids

opioid banner

Oregon has made national headlines as having the second highest rate of opioid drug abuse in the nation; an alarming story to many who are involved in health care across the state. This statistic has been a call to action and OMA joined the growing statewide efforts to address this issue. 

2018 Oregon Progress Update

Findings from a May 2018 AMA report demonstrate that efforts by the Oregon Medical Association (OMA) and partner organizations are having the encouraging effects of tackling the opioid crisis in Oregon—but that continuing the positive trend will require sustained and vigorous action on the part of the state’s lawmakers and healthcare providers, as well as the general public.

 

OMA Opioid Efforts

Leading

  • Formation of OMA's Opioids Task Force in 2015 
  • Task Force Charter:  The Task Force is charged with developing OMA's statewide platform for issues surrounding the prescribing and management of opioids including policy creations, legislative review, member and community education and resources, issue expertise and other issues as they arise around opioid misuse and abuse, as well as appropriate pain management.

OMA Policy Statement

Prescribing Opioids

The OMA adopts the following overarching policy regarding prescription opioids, including, but not limited to, the following:

The OMA recognizes the vital role that physicians and physician assistants (PAs) play in the provision of appropriate pain management services including prescribing opioid analgesics for assessed pain.

The OMA supports the shared decision making process between the prescriber and the patient that includes weighing the risks and benefits of starting or continuing opioid therapy.

The OMA supports the education of physicians and physician assistants regarding the proper assessment, referral and treatment of chronic pain as well as strategies to lessen the diversion, misuse, abuse, and unintentional overdose, and death from opioid pain relievers.

The OMA supports continued clinician input into pain management regulations and legislation.

The OMA encourages physicians and physician assistants to use all available risk assessment tools to improve safety in pain management as is fitting to their practice. The OMA endorses: 

    • Continued research and adoption of evidence-based guidelines for the safe treatment of chronic pain
    • Increased access to non-opioid modalities that are appropriate for pain care and covered by insurance
    • The regular use of the Prescription Drug Monitoring Program (PDMP)
    • Efforts to make the Prescription Drug Monitoring Program (PDMP) more easily accessible to precribers
    • Regular adherence monitoring and evaluation of a patient's opioid therapy
    • Increased access to comprehensive addiction evaluation and/or treatment for individuals diagnosed with opioid use disorder

Finally, the OMA endorses public and community education for greater awareness of the risks of opioid prescriptions and options for pain management.

The OMA will work in collaboration with other organizations including other medical associations to address the issue of opioid safety in a holistic manner that ensures patient safety and wellbeing remain at the forefront of prescribing practices. (June 2016)

Legislative Action 

  • 2018  HB 4143 - PASSED
    • Requires the Oregon Department of Consumer and Business Services (DCBS) to study the barriers to medication-assisted treatment for substance use disorder, including access to treatment in rural and underserved areas, and report back to the Legislature with findings
    • Includes the establishment of an Oregon Health Authority (OHA) pilot project to assess the effectiveness of peer recovery support mentors within Emergency Departments
    • Requires providers licensed to prescribe opioids to register with the Oregon Prescription Drug Monitoring Program (PDMP) by July 1, 2018
  • 2017 HB 3440 - PASSED
    • Create and maintain a database for addiction treatment providers and current county overdose statistics
    • Eases prior authorization rules on withdrawal medication
    • Allows pharmacists to dispense naloxone without requiring the patient to complete formal individualized training
    • Enhances the PDMP by streamlining provider enrollment, creating opportunities to identify and review risky prescribing practices, and ensuring appropriate education of prescribers on the state’s recently adopted prescribing guidelines.
  • 2017 HB 2114 - PASSED
    • Requires the Oregon Medical Board to endorse Oregon’s Opioid Prescription Guidelines and inform licensees of safe prescribing practices
  • 2016 OMA's HB 4124 - PASSED (OMA legislative session win) - OMA introduced HB 4124 to develop policy that:
    • Develops policy to integrate the PDMP into existing technology to streamline the use of the PDMP
    • Allows for pharmacists to prescribe and distribute naloxone, without a prescription
  • 2015 SB 839 - PASSED 
    • "Good Samaritan law" - provides legal immunity to individuals who report an overdose/experience an overdose. Cannot be prosecuted for possession, frequenting location known to sell drugs or possession of paraphernalia with intent to sell/deliver 
  • 2013 SB 470 - PASSED
    • Granted delegate access to the PDMP (designated staff of licensed health care professional can individually log in and pull prescription data)
    • Requires specific data to be collected and entered on each logged prescription (including number of days prescribed, refills, where dispensed, etc.)
    • Allows for disclosure of prescriptions by DEA number

Policy 

  • Monitored and submitted comments to the CDC on the initially proposed guidelines for prescribing opioid for chronic pain
  • Board of Trustees approved adoption of new opioids prescribing guidelines from the Oregon Opioids Prescribing Guidelines Task Force
  • Action by OMA Board of Trustees
    • Approved overarching policy on opioids
    • Approved adoption of opioids prescribing guidelines from the Oregon Opioids Prescribing Guidelines Task Force
    • Approved adoption of Oregon Pregnancy and Opioids Workgroup Recommendations
  • Participated in rules advisory committee for HB 4124
  • Monitored and commented on Health Evidence Review Commission coverage guidelines, including updated guidance on opioids for conditions of the back and spine
  • Advocated for streamlined PDMP application and achieved removal of notarization requirement
  • Advocated against tying physician performance to Consumer Assessment of Healthcare Providers and Systems (CAHPS) satisfaction measures; negative scores can influence opioid prescription
  • Assist members on regulatory questions such as pain management contracts and enforcement, medication-assisted treatment resources, false prescription fraud, and intersection of marijuana and opioids

Communications

  • Periodic articles on local and national opioid-related efforts
  • Social Media around opioids, addiction, and mental health
  • Development of a dedicated Opioids Epidemic webpage on the OMA website
  • Periodic articles on local opioid-related efforts
  • Medicine in Oregon, Winter 2016 - Opiod Abuse: Oregon Tackles Escalating Public Health Epidemic

Education

  • 2018 - OMA Annual Conference 2018 with Keynote Sam Quinones speaking about the opioid Epidemic and a breakout session dedicated to prescribing guidelines for acute pain
  • 2018 - Working with AMA on a pilot program to reduce harm from inappropriate use of opioid analgesics
  • 2018 - Developing Opioids Modules and a series of CME webinars
  • OMA Annual Conference 2016, dedicated to the crisis
  • Fall Convocation on opioids in 2013
  • Free Enduring CME:  ER/LA Opioid REMS: Achieving Safe Use While Improving Patient Care
  • Joint Providership, including OMA Accreditation, for programs presented by the Oregon Coalition for the Responsible Use of Medicine and Oregon Pain Guidance

Collaboration

  • OMA participates on or has participated in the following groups:
    • AMA Opioids Task Force
    • Oregon Governor's Opioid Epidemic Task Force
    • Oregon Coalition for the Responsible Use of Medicine
    • PDMP Commission
    • Oregon Health Leadership Council Opioids Group
    • Oregon Health Leadership Council Opioids Education Subgroup
    • Oregon PDMP Integration Steering Council
    • Oreogn Opioids Prescribing Guidelines Task Force
    • Oregon Pregnancy and Opioids Workgroup
    • Oregon Prescribing Guidelines for Acute Pain Workgroup

Foundation

  • The Oregon Medical Education Foundation has provided grants for Opioids Education to the OMA and to Bay Area Hospital in Southern Oregon.

National Resources

AMA

CDC

 CMS

SAMHSA

Oregon Resources

OHA

Oregon Workers' Compensation Division

Oregon Pain Guidance 

Lines For Life

Other Resources

Providers Clinical Support System - Opioids (PCSS-O)

Turn The Tide

CLEAR (Children Learning through Education and Research) Alliance 

  • Heroin Educational flyers and other resources

Opioid Risk 

  • Prescription Opioid Misuse Risk Assessment Tools
Physicians for Responsible Opioid Prescribing

Start Your Recoverya free, confidential tool that helps individuals take steps toward a healthy relationship with drugs and alcohol

v2 2016