Pharmacological Pain Management, the Evolving Role of Opioids, and Improving Education of Health Care Providers
|
|
|
- Basil Mathews
- 5 years ago
- Views:
Transcription
1 Pharmacological Pain Management, the Evolving Role of Opioids, and Improving Education of Health Care Providers James P. Rathmell, M.D. Chair, Department of Anesthesiology, Perioperative and Pain Medicine Brigham and Women s Health Care Leroy A. Vandam & Benjamin G. Covino Professor of Anaesthesia Harvard Medical School Boston, Massachusetts USA
2 Conflict of Interest Director, American Board of Anesthesiology The ABA oversees preparation and administration of the physician subspecialty board certification examination in Pain Medicine The National Academies Workshop Washington, DC September 22, 2016
3 Objectives Explain the evolution of increased use of opioids for the treatment of chronic pain Outline recent trends in the pharmacological management of pain, including the evolving role for opioid analgesics Describe gaps in pain research and education The National Academies Workshop Washington, DC September 22, 2016
4 THE BURDEN OF PAIN An Unmet Need 2011: Relieving Pain in America
5
6 THE OPIATES & OPIOIDS The Universal Antidote 10,000 B.C. 2016
7 Acute Pain and Opioids Opioid analgesics are used to effectively treat acute pain in the postoperative period and following trauma Opioid analgesics are an integral part of treating pain and minimizing suffering in those with advanced illness
8 Chronic Pain and Opioids Until recent years, use of opioids for treating chronic pain was limited The potential for adverse effects, including addiction and death due to overdose, has been known for as long as opium has been in use
9 Chronic Pain and Addiction The likelihood of patients progressing from taking legitimately prescribed opioids for pain to opioid addiction is low Pain in those with pre-existing opioid addiction is extremely high Individuals with severe pain and opioid addiction have over five times higher relapse rate compared with their counterparts with opioid addiction but no pain Wachholtz A et al. Subst Abuse Rehabil 2011; 2:
10 OPIOIDS FOR CHRONIC PAIN A Newfound Panacea
11 Opioids for Chronic Pain these papers represent a phenomenon akin to breaking the sound barrier. Our attitudes to narcotics are influenced by unfounded prejudice based on street addicts Melzack R. The tragedy of needless pain: a call for social action. IASP President s Address, Vth World Congress on Pain, 1988.
12 Opioids for Chronic Pain New Pharmacologic Preparations 1987: Extended-release morphine (MS-Contin ) 1990: Transdermal fentanyl (Duragesic ) 1996: Extended-release oxycodone (OxyContin ) 1998: Oral transmucosal fentanyl (Actiq ) 2006: Oral buccal fantanyl (Fentora ) 2010: Extended-release hydropmorphone (Exalgo ) 2013: Extended-release hydrocodone (Zohydro ER )
13 AN EPIDEMIC EMERGES Prescription Drug Abuse
14 An Epidemic Emerges
15 An Epidemic Emerges
16 Recent Trends PHARMACOLOGICAL PAIN MANAGEMENT : The Evolving Role for Opioids
17 New Analgesics No novel analgesics Abuse-deterent formulations of opioids New extended-release formulations New routes of delivery for some agents (topical, transmucosal) Label extension to new indications Little impact on managing those with chronic pain Xtanza (oxycodone) extended release Onzetra Xsail (sumatriptan nasal powder) Troxyca ER (oxycodone + naltrexone) Belbuca (buprenorphine) Vivlodex (meloxicam) Dyloject (diclofenac sodium) Injection Targiniq ER (oxycodone hydrochloride + naloxone hydrochloride) extended-release tablets Tivorbex (indomethacin) Xartemis XR (oxycodone hydrochloride and acetaminophen) extended release Zohydro ER (hydrocodone bitartrate) Extended- Release Capsules Zubsolv (buprenorphine and naloxone) Lyrica (pregabalin) Subsys (fentanyl sublingual spray)
18 Naloxone Narcan (naloxone hydrochloride); For emergency treatment of known or suspected opioid overdose; Approved November 2015 The effectiveness of naloxone in preventing opioid-related overdose deaths and who should receive this drug, particularly among those on chronic opioid therapy for pain, are unknown
19 Emphasis on Mimimizing use of Opioid Analgesics Trends in the Pharmacological Management of Acute Pain Enhanced Recovery After Surgery (ERAS) protocols that combine multiple analgesics as part of comprehensive protocols have become commonplace Education for providers with emphasis on use of the smallest effective doses and shortest duration of analgesics after surgery have become common
20 ARE OPIOIDS EFFECTIVE? Evaluating the Scientific Evidence Twenty Years of Scientific Inquiry
21 Are Opioids Effective? A 2015 NIH workshop centered on the prescription drug abuse epidemic There is not one study long-term (>1 year) outcomes related to pain, function, quality of life, opioid abuse, or addiction Observational studies suggest that opioid therapy for chronic pain is associated with increased risk for overdose, opioid abuse, fractures, myocardial infarction, and markers of sexual dysfunction For some of these harms, higher dose was associated with increased risk Chou R et al. Intern Med 2015;162:
22 CHRONIC OPIOIDS TODAY Addressing the Epidemic 2016 and Beyond
23 Chronic Opioids Today The 2011 White House plan calls for: Expanded education of patients and health care practitioners An urgent call for new research Expansion of existing Prescription Drug Monitoring Programs (PDMPs) Better means for disposing of unneeded prescription drugs Tougher enforcement of existing laws focused on identifying and prosecuting practitioners
24 Chronic Opioids Today
25 Chronic Opioids Today
26 Chronic Opioids Today How do we appropriately select and manage patients with chronic non-cancer pain for chronic opioid therapy to treat only those with the greatest chance to benefit while minimizing the risk to the individual who is treated and our society?
27 Chronic Opioids Today Identify at-risk patients using validated screening tools Incorporate frequent monitoring, periodic urine screens, opioid therapy agreements, opioid checklists, and motivational counseling Jamison RN, Mao J. Opioid analgesics. Mayo Clin Proc 2015; 90:
28 Chronic Opioids Today How do we identify and best manage those patients receiving chronic opioid therapy who are not benefiting from this course of treatment?
29 Chronic Opioids Today Discontinuation and/or maintenance of chronic opioid therapy Guides for tapering opioids are non-existent Most studies are in those under treatment for substance use disorder Psychiatric co-morbidities and fears of medico-legal risk hinder treatment Berna C et al. Mayo Clin Proc 2015;90:
30 Chronic Opioids Today JAMA Intern Med. 2016;176(2):
31 Physician Training in Pain Medicine Number of ABMS Pain Medicine Diplomates Anesthesiologists Non-Anesthesiologists Total
32
33 Pharmacological Pain Management, the Evolving Role of Opioids, and Improving Education of Health Care Providers Conclusions RESEARCH: Aimed at developing new analgesics that are more effective and less subject to abuse RESEARCH: Aimed at determining who will benefit most from chronic opioid therapy with an emphasis on measurable improvements in function RESEARCH: Aimed at identifying patients who are not benefiting from chronic opioid therapy and determining how best to discontinue opioids
34 Pharmacological Pain Management, the Evolving Role of Opioids, and Improving Education of Health Care Providers Conclusions EDUCATION: Improving the education of all health care providers in the compassionate and evidencebased management of chronic pain is needed INNOVATION: The magnitude of this problem calls for the adoption of new models for collaborative care among primary care and specialty providers for managing patients with chronic pain with an emphasis on measurable improvement in function
35 Boston Public Library Boston, Massachusetts, 2012
Long-Acting Opioid Analgesics
Market DC Long-Acting Opioid Analgesics Override(s) Prior Authorization Step Therapy Quantity Limit Approval Duration Initial request: 3 months Maintenance Therapy: Additional prior authorization required
Long-Acting Opioid Analgesics
Market DC Long-Acting Opioid Analgesics Override(s) Prior Authorization Step Therapy Quantity Limit Approval Duration Initial request: 3 months Maintenance Therapy: Additional prior authorization required
The Challenge of Treating Pain
FDA Charge to the Committee: FDA Opioid Action Plan and Incorporating the Broader Public Health Impact into the Formal Risk-Benefit Assessment for Opioids Robert M. Califf, MD Commissioner of Food and
APPROVED PA CRITERIA. Initial Approval: January 10, 2018 Revised Dates: April 11, 2018 CRITERIA FOR PRIOR AUTHORIZATION
Initial Approval: January 10, 2018 Revised Dates: April 11, 2018 CRITERIA FOR PRIOR AUTHORIZATION PROVIDER GROUP Pharmacy Opioid Products Indicated for Pain Management MANUAL GUIDELINES All dosage forms
Embeda. Embeda (morphine sulfate and naltrexone hydrochloride) Description
Federal Employee Program 1310 G Street, N.W. Washington, D.C. 20005 202.942.1000 Fax 202.942.1125 5.70.39 Subject: Embeda Page: 1 of 6 Last Review Date: March 18, 2016 Embeda Description Embeda (morphine
Disposal of Unused Medicines: What You Should Know
1 of 8 3/12/16 11:14 PM U.S. Food and Drug Administration Protecting and Promoting Your Health Disposal of Unused Medicines: What You Should Know Topics on this page Overview List of Medicines Recommended
Limitations of use: Subsys may be dispensed only to patients enrolled in the TIRF REMS Access program (1).
Federal Employee Program 1310 G Street, N.W. Washington, D.C. 20005 202.942.1000 Fax 202.942.1125 5.70.21 Subject: Subsys Page: 1 of 5 Last Review Date March 17, 2017 Subsys Description Subsys (fentanyl
Carefirst. +.V Family of health care plans
Family of health care plans Prior Authorization Form 1361M Opioids ER MME Limit and Post Limit This fax machine is located in a secure location as required by HPAA regulations. Complete/review information,
20/0.8mg, 30/1.2mg, Films 90 MME/day Belbuca (buprenorphine) 75mcg, 150mcg, 300mcg, 450mcg 60 units per 90 days
Pre - PA Allowance Quantity Extended Release Tablets or Capsules 90 MME/day Medication Strength Avinza (morphine) 60mg, 75mg, 90mg Embeda (morphine /naltrexone) 50/2mg, 60/2.4mg, 80/3.2mg Exalgo (hydromorphone)
AETNA BETTER HEALTH Prior Authorization guideline for Narcotic Analgesic Utilization
AETNA BETTER HEALTH Prior Authorization guideline for Narcotic Analgesic Utilization Policy applies to all formulary and non-formulary schedules II V opioid narcotics, including tramadol and codeine, as
Disposal of Unused Medicines: What You Should Know
1 of 8 04/27/2016 1:37 AM U.S. Food and Drug Administration Protecting and Promoting Your Health Disposal of Unused Medicines: What You Should Know Topics on this page (http://www.fda.gov/aboutfda/aboutthiswebsite
Long-Acting Opioid. Policy Number: Last Review: 12/2017 Origination: 09/2013 Next Review: 09/2018
Long-Acting Opioid Policy Number: 5.02.519 Last Review: 12/2017 Origination: 09/2013 Next Review: 09/2018 Policy Blue Cross and Blue Shield of Kansas City (Blue KC) will provide coverage for long-acting
Prior Authorization for Opioid Products Indicated for Pain Management
Kansas Medical Assistance Program PA Phone 800-933-6593 PA Fax 800-913-2229 Amerigroup PA Pharmacy Phone 855-201-7170 PA Pharmacy Fax 800-601-4829 Sunflower PA Pharmacy Phone 877-397-9526 PA Pharmacy Fax
Pharmacy Medical Necessity Guidelines: Opioid Analgesics
Pharmacy Medical Necessity Guidelines: Effective: January 1, 2019 Prior Authorization Required Type of Review Care Management Not Covered Type of Review Clinical Review Pharmacy (RX) or Medical (MED) Benefit
Rule Governing the Prescribing of Opioids for Pain
Rule Governing the Prescribing of Opioids for Pain 1.0 Authority This rule is adopted pursuant to Sections 14(e) and 11(e) of Act 75 (2013) and Sections 2(e) and 2a of Act 173 (2016). 2.0 Purpose This
Opioid Prescribing Guidelines for Patients in the Emergency Department
Opioid Prescribing Guidelines for Patients in the Emergency Department and Immediate Care Centers These guidelines are meant to assist clinicians in treating patients with acute and chronic pain in the
QUANTITY LIMIT AND POST LIMIT PRIOR AUTHORIZATION CRITERIA
DRUG CLASS QUANTITY LIMIT AND POST LIMIT PRIOR AUTHORIZATION CRITERIA EXTENDED-RELEASE OPIOID ANALGESICS BRAND NAME (generic) ARYMO ER (morphine sulfate extended-release tablets) AVINZA (morphine extended-release
Understanding and Combating the Heroin Epidemic
Understanding and Combating the Heroin Epidemic Kelly Dunn, Ph.D. Assistant Professor; Johns Hopkins School of Medicine Department of Psychiatry and Behavioral Sciences 1 Talk Outline What is causing the
Nucynta IR/ Nucynta ER (tapentadol immediate-release and extendedrelease)
Federal Employee Program 1310 G Street, N.W. Washington, D.C. 20005 202.942.1000 Fax 202.942.1125 Subject: Nucynta Page: 1 of 7 Last Review Date: March 18, 2016 Nucynta Description Nucynta IR/ Nucynta
Duragesic patch. Duragesic patch (fentanyl patch) Description
1310 G Street, N.W. Washington, D.C. 20005 202.942.1000 Fax 202.942.1125 5.70.31 Subject: Duragesic patch Page: 1 of 6 Last Review Date: March 18, 2016 Duragesic patch Description Duragesic patch (fentanyl
EXTENDED RELEASE OPIOID DRUGS
RATIONALE FOR INCLUSION IN PA PROGRAM Background Hydrocodone (Hysingla ER, Vantrela ER, Zohydro ER), hydromorphone (Exalgo), morphine sulfate (Arymo ER, Avinza, Embeda, Kadian, MorphaBond, MS Contin),
Prior Authorization Guideline
Guideline GL-35952 Opioid Quantity Limit Overrides Formulary OptumRx Formulary Note: Approval Date 7/10/2017 Revision Date 7/10/2017 Technician Note: P&T Approval Date: 2/16/2010; P&T Revision Date: 7/12/2011
Education Program for Prescribers and Pharmacists
Transmucosal Immediate Release Fentanyl (TIRF) Products Risk Evaluation and Mitigation Strategy (REMS) Education Program for Prescribers and Pharmacists Products Covered Under this Program Abstral (fentanyl)
Demerol (meperidine oral tablet, oral solution), Meperitab (oral tablet)
Federal Employee Program 1310 G Street, N.W. Washington, D.C. 20005 202.942.1000 Fax 202.942.1125 Subsection: Analgesics and Opioids Original Policy Date: May 8, 2015 Subject: Meperidine Page: 1 of 5 Last
: Opioid Quantity Limits
March 7, 2017 2017-09: Opioid Quantity Limits The Louisiana Department of Health (LDH), in conjunction with the Louisiana Medicaid Drug Utilization Review (DUR) Board, has revised quantity limits for selected
UnitedHealthcare Pharmacy Clinical Pharmacy Programs
UnitedHealthcare Pharmacy Clinical Pharmacy Programs Program Number 2017 P 3053-7 Program Step Therapy Long Acting Opioids Medication Includes both brand and generic versions of the listed products unless
TREATING OPIOID ADDICTION IN HOMELESS POPULATIONS
TREATING OPIOID ADDICTION IN HOMELESS POPULATIONS Challenges and Opportunities Providing Medication Assisted Treatment (Buprenorphine) August 18, 2016 SPEAKERS TODAY Nilesh Kalyanaraman, MD, Chief Health
NATL. II. Health Net Approved Indications and Usage Guidelines: Diagnosis of cancer AND. Member is on fentanyl transdermal patches AND
Coverage of drugs is first determined by the member s pharmacy or medical benefit. Please consult with or refer to the Evidence of Coverage document I. FDA Approved Indications: The management of breakthrough
Transmucosal Immediate Release Fentanyl (TIRF) Prior Authorization, (Through Generic), and Quantity Limit Program Summary
Transmucosal Immediate Release Fentanyl (TIRF) Prior Authorization, (Through Generic), and Quantity Limit Program Summary FDA APPROVED INDICATIONS DOSAGE 1-5 Drug Indication Dosage Abstral (fentanyl sublingual
Key points. o Potential for nonmedical use, abuse, and diversion of new products
RADARS System Technical Report # 2012Q2-1 Use of unique recipients of dispensed drug (URDD) in assessing the burden of abuse, misuse, and diversion of prescription opioid products Key points Considering
UnitedHealthcare Pharmacy Clinical Pharmacy Programs
UnitedHealthcare Pharmacy Clinical Pharmacy Programs Program Number 2018 P 3053-9 Program Step Therapy Long Acting Opioids Medication Includes both brand and generic versions of the listed products unless
ER/LA Opioid REMS: Achieving Safe Use While Improving Patient Care
ER/LA Opioid REMS: Achieving Safe Use While Improving Patient Care In August 2014, the Food and Drug Administration (FDA) updated the Extended- Release/Long Acting Opioids REMS Blueprint (BP). CO*RE has
Methadone. Description
Federal Employee Program 1310 G Street, N.W. Washington, D.C. 20005 202.942.1000 Fax 202.942.1125 5.70.41 Subject: Methadone Page: 1 of 8 Last Review Date: March 18, 2016 Methadone Description Dolophine
MEDICARE Program Policies & Procedures POLICY NUMBER: Medicare D-111
POLICY: Medicare Part D Formulary-Level Cumulative Opioid and Opioid/Buprenorphine POS Edits MEDICARE Program Policies & Procedures POLICY NUMBER: Medicare D-111 Policy for contracts H3351, S3521 and H3335
CDC Guideline for Prescribing Opioids for Chronic Pain. Centers for Disease Control and Prevention National Center for Injury Prevention and Control
CDC Guideline for Prescribing Opioids for Chronic Pain Centers for Disease Control and Prevention National Center for Injury Prevention and Control THE EPIDEMIC Chronic Pain and Prescription Opioids 11%
Opioids, Extended Release (ER) Quantity Limit Criteria Program Summary
Opioids, Extended Release (ER) Quantity Limit Criteria Program Summary This program applies to Commercial, GenPlus, NetResults A series, Netresults F series and Health Insurance Marketplace. Belbuca is
Treatment of Pain in an Emergent Setting
Updated: October 22, 2018 Prescribing Guidelines for Pennsylvania Treatment of Pain in an Emergent Setting Opioids, including heroin and fentanyl, contribute to thousands of overdose deaths in Pennsylvania
Opioid Analgesics. Recommended starting dose for opioid-naïve patients
Opioid Analgesics Goals: Restrict use of opioid analgesics to OHP-funded conditions with documented sustained improvement in pain and function and with routine monitoring for opioid misuse and abuse. Promote
Opioid Analgesic Treatment Worksheet
Opioid Analgesic Treatment Worksheet Aetna Better Health of Louisiana Fax: 1 844 699 2889 www.aetnabetterhealth.com/louisiana/providers/pharmacy LA Legacy Fee for Service (FFS) Medicaid Fax: 1 866 797
Slide 1. Slide 2. Slide 3. Opioid (Narcotic) Analgesics and Antagonists. Lesson 6.1. Lesson 6.1. Opioid (Narcotic) Analgesics and Antagonists
Slide 1 Opioid (Narcotic) Analgesics and Antagonists Chapter 6 1 Slide 2 Lesson 6.1 Opioid (Narcotic) Analgesics and Antagonists 1. Explain the classification, mechanism of action, and pharmacokinetics
See Important Reminder at the end of this policy for important regulatory and legal information.
Clinical Policy: Transmucosal Immediate Release Fentanyl Products Reference Number: CP.CPA.211 Effective Date: 11.16.16 Last Review Date: 11.17 Line of Business: Commercial Revision Log See Important Reminder
New Guidelines for Opioid Prescribing
New Guidelines for Opioid Prescribing What They Mean for Elders with Chronic Pain Manu Thakral, PhD, ARNP Kaiser Permanente Washington Health Research Institute Kaiser Permanente Washington Health Research
Readopt with amendment Med 502, effective (Document #11090), to read as follows:
Adopted Rules 11-2-16 1 Readopt with amendment Med 502, effective 5-3-16 (Document #11090), to read as follows: PART Med 502 OPIOID PRESCRIBING Med 502.01 Applicability. This part shall apply to the prescribing
See Important Reminder at the end of this policy for important regulatory and legal information.
Clinical Policy: Reference Number: CP.CPA.259 Effective Date: 11.16.16 Last Review Date: 11.17 Line of Business: Commercial Revision Log See Important Reminder at the end of this policy for important regulatory
Morphine Sulfate Hydromorphone Oxymorphone
Federal Employee Program 1310 G Street, N.W. Washington, D.C. 20005 202.942.1000 Fax 202.942.1125 5.02.33 Subject: Morphine Drug Class Page: 1 of 8 Last Review Date: June 19, 2015 Morphine Sulfate Hydromorphone
Abuse, Misuse, and Diversion of Prescription Opioids: Evaluating the Problem and Proposed Solutions
Abuse, Misuse, and Diversion of Prescription Opioids: Evaluating the Problem and Proposed Solutions Eric Lavonas, MD, FACEP, FACMT, FAACT Associate Director, Rocky Mountain Poison & Drug Center Denver
Cigna Drug and Biologic Coverage Policy
Cigna Drug and Biologic Coverage Policy Subject Opioid Therapy Table of Contents Coverage Policy... 1 General Background... 4 Coding/Billing Information... 7 References... 7 Effective Date..1/1/2018 Next
Disposal by Flushing of Certain Unused Medicines: What
Disposal by Flushing of Certain Unused Medicines: What You Should Know Drugs Page 1 of 5 Disposal by Flushing of Certain Unused Medicines: What You Should Know Overview Frequently Asked Questions List
Campus Narcan Project OPIOID OVERDOSE FIRST RESPONDER TRAINING
Campus Narcan Project OPIOID OVERDOSE FIRST RESPONDER TRAINING Opioid Epidemic Prescription Opiods Can be prescribed by doctors to treat moderate to severe pain, but can also have serious risks and side
Blueprint for Prescriber Continuing Education Program
CDER Final 10/25/11 Blueprint for Prescriber Continuing Education Program I. Introduction: Why Prescriber Education is Important Health care professionals who prescribe extended-release (ER) and long-acting
Buprenorphine as a Treatment Option for Opioid Use Disorder
Buprenorphine as a Treatment Option for Opioid Use Disorder Joji Suzuki, MD Assistant Professor of Psychiatry Harvard Medical School Director, Division of Addiction Psychiatry Brigham and Women s Hospital
Preventing Prescription Opioid Misuse Among Student Athletes
Preventing Prescription Opioid Misuse Among Student Athletes Massachusetts is in the midst of an opioid epidemic. Athletes in particular, due to their risk of injury and the resulting pain, may be at risk
HOPE. Considerations. Considerations ISING. Safe Opioid Prescribing Guidelines for ACUTE Non-Malignant Pain
Due to the high level of prescription drug use and abuse in Lake County, these guidelines have been developed to standardize prescribing habits and limit risk of unintended harm when prescribing opioid
How To Green My Pharmacy. Prepared and presented by Luna El Bizri,Pharm-D, Community Pharmacist
How To Green My Pharmacy Prepared and presented by Luna El Bizri,Pharm-D, Community Pharmacist Learning Objectives At the end of this presentation, pharmacists will be able to : 1. Understand the negative
Medical Policy An independent licensee of the Blue Cross Blue Shield Association
Opioids, Extended Release (ER) Page 1 of 12 Medical Policy An independent licensee of the Blue Cross Blue Shield Association Title: Opioids, Extended Release (ER) Prime Therapeutics will review Prior Authorization
Opioid Use Issues: All the Players
Opioid Use Issues: All the Players Objectives After review, the participant will be able to: 1) Identify criteria for opioid use disorders Andrew J. McLean, MD, MPH Medical Director, ND Department of Human
Addressing Drug Diversion
Webinar Objectives Addressing Drug Diversion Bernice Burkarth, MD, HMDC, FAAHPM BBurkarth@treasurehealth.org October12, 2017 At the completion of this Webinar, participants will be able to: Identify tools
Opioid Analgesic Treatment Worksheet
Opioid Analgesic Treatment Worksheet Aetna Better Health of Louisiana Fax: 1 844 699 2889 www.aetnabetterhealth.com/louisiana/providers/pharmacy LA Legacy Fee for Service (FFS) Medicaid Fax: 1 866 797
Opioids drive continued increase in drug overdose deaths
CDC: Drug overdose deaths increase for 11th consecutive year Opioids drive continued increase in drug overdose deaths Atlanta, GA, USA (February 20, 2013) - Drug overdose deaths increased for the 11th
Bree Collaborative AMDG Opioid Prescribing Guidelines Workgroup. Opioid Prescribing Metrics - DRAFT
Bree Collaborative AMDG Opioid Prescribing Guidelines Workgroup Opioid Prescribing Metrics - DRAFT Definitions: Days Supply: The total of all opioid prescriptions dispensed during the calendar quarter
2004-L SEPTEMBER
BULLETIN INTELLIGENCE Buprenorphine: Potential for Abuse Product No. 2004-L0424-013 SEPTEMBER 2004 U. S. D E P A R T M E N T O F J U S T I C E NDIC Within the past 2 years buprenorphine a Schedule III
Cynthia B. Jones, Director Department of Medical Assistance Services (DMAS)
Department of Medical Assistance Services 600 East Broad Street, Suite 1300 Richmond, Virginia 23219 MEDICAID MEMO http://www.dmas.state.va.us TO: All Prescribing Providers, Pharmacists, and Managed Care
CLINICAL POLICY Clinical Policy: Extended Release Opioid Analgesics
Reference Number: AZ.CP.PMN.97 Effective Date: 02.11 Last Review Date: 02.18 Line of Business: Medicaid- AHCCCS Revision Log See Important Reminder at the end of this policy for important regulatory and
Welcome - we will begin the webinar shortly Please read the participation tips below:
Welcome - we will begin the webinar shortly Please read the participation tips below: All guest phones have been muted: Background noises, conversations, white noise etc., can be disruptive to a webinar.
See Important Reminder at the end of this policy for important regulatory and legal information.
Clinical Policy: Opioid Analgesics Reference Number: HIM.PA.139 Effective Date: 12.01.17 Last Review Date: 11.17 Line of Business: Health Insurance Marketplace Revision Log See Important Reminder at the
Addressing the Opioid Epidemic: Prescribing Opioids for Non-Cancer Pain
Addressing the Opioid Epidemic: Prescribing Opioids for Non-Cancer Pain Ajay D. Wasan, MD, MSc Professor of Anesthesiology and Psychiatry Vice Chair for Pain Medicine, Department of Anesthesiology University
Wisconsin Opioid Prescribing Guideline Draft Scope and purpose of the guideline
Wisconsin Opioid Prescribing Guideline Draft Scope and purpose of the guideline: To help providers make informed decisions about acute and chronic pain treatment -pain lasting longer than three months
USE OF BUPRENORPHINE FOR CHRONIC PAIN
Psychiatry and Addictions Case Conference UW Medicine Psychiatry and Behavioral Sciences USE OF BUPRENORPHINE FOR CHRONIC PAIN MARK SULLIVAN, MD, PHD PSYCHIATRY AND BEHAVIORAL SCIENCES ANESTHESIOLOGY AND
Pharmacotherapy for opioid addiction. Judith Martin, MD Medical Director BAART Turk Street Clinic San Francisco
Pharmacotherapy for opioid addiction Judith Martin, MD Medical Director BAART Turk Street Clinic San Francisco Disclosure slide No commercial conflicts to disclose. Gaps in current treatment of opioid
A National Perspective on the Abuse and Diversion of Prescription Drugs
A National Perspective on the Abuse and Diversion of Prescription Drugs Hilary L. Surratt, Ph.D Steven P. Kurtz, Ph.D. ARSH: Center for Applied Research on Substance Use and Health Disparities Faculty
ACCG Mental Health Summit
ACCG Mental Health Summit Sheila Pierce, Opioid Program Coordinator Director, Prescription Drug Management Program Discussion 1. Overview Opioid Problem in GA - Video 2. DPH Opioid Program 3. Priorities
See Important Reminder at the end of this policy for important regulatory and legal information.
Clinical Policy: Reference Number: HIM.PA.139 Effective Date: 12.01.17 Last Review Date: 02.18 Line of Business: Health Insurance Marketplace Revision Log See Important Reminder at the end of this policy
Opioids and Older Adults
Opioids and Older Adults Kate Lorig, DrPH kate@selfmanagementresource.com Beth Darnall, Ph.D. Twitter: @BethDarnall Heather Zuercher Let me bring you our sponsors SMRC@selfmanagementresource.com
Medication Policy Manual. Date of Origin: January 1, Topic: Extended-release (ER) Opioid Medication Products for Pain
Medication Policy Manual Topic: Extendedrelease (ER) Opioid Medication Products for Pain Policy No: dru515 Date of Origin: January 1, 2018 Committee Approval Date: January 19. 2018 Next Review Date: December
OCCUPATIONAL AND PROFESSIONAL LICENSING MEDICINE AND SURGERY PRACTITIONERS MANAGEMENT OF PAIN AND OTHER CONDITIONS WITH CONTROLLED SUBSTANCES
TITLE 16 CHAPTER 10 PART 14 OCCUPATIONAL AND PROFESSIONAL LICENSING MEDICINE AND SURGERY PRACTITIONERS MANAGEMENT OF PAIN AND OTHER CONDITIONS WITH CONTROLLED SUBSTANCES 16.10.14.1 ISSUING AGENCY: New
New Guidelines for Prescribing Opioids for Chronic Pain
New Guidelines for Prescribing Opioids for Chronic Pain Andrew Lowe, Pharm.D. CAPA Meeting October 6, 2016 THE EPIDEMIC Chronic Pain and Prescription Opioids 11% of Americans experience daily (chronic)
Opioid Management of Chronic (Non- Cancer) Pain
Optima Health Opioid Management of Chronic (Non- Cancer) Pain Guideline History Original Approve Date 5/08 Review/Revise Dates 11/09, 9/11, 9/13, 09/15, 9/17 Next Review Date 9/19 These Guidelines are
Medication Assisted Treatment
Meeting the Needs of Your Clients: Building Competencies in Mental Health and Addiction Services Medication Assisted Treatment November 5, 2018 In partnership with: House Keeping Because this is a webinar,
See Important Reminder at the end of this policy for important regulatory and legal information.
Clinical Policy: Transmucosal Immediate Release Fentanyl Products Reference Number: CP.HNMC.211 Effective Date: 11.16.16 Last Review Date: 11.17 Line of Business: Medicaid Medi-Cal Revision Log See Important
Medication Policy Manual. Topic: Extended-release (ER) Opioid Medication Products for Pain. Date of Origin: January 1, 2018
Independent licensees of the Blue Cross and Blue Shield Association Medication Policy Manual Topic: Extended-release (ER) Opioid Medication Products for Pain Policy No: dru515 Date of Origin: January 1,
THA Medication Safety Summit. Wesley Geminn, PharmD, BCPP
THA Medication Safety Summit Wesley Geminn, PharmD, BCPP Current Trends: Overdose Deaths in 2017 72,000 Or 197 per day 8 per hour National Opioid Overdose Statistics https://www.drugabuse.gov/related-topics/trendsstatistics/overdose-death-rates
MEDICATION ASSISTED TREATMENT
MEDICATION ASSISTED TREATMENT MODULE 14 ALLIED TRADES ASSISTANCE PROGRAM PREVENTATIVE EDUCATION: SUBSTANCE USE DISORDER Medication Assisted Treatment Types of Medication Assisted Treatment: Methadone Naltrexone
SUBOXONE Film, SUBOXONE Tablets, and SUBUTEX Tablets. Risk Evaluation and Mitigation Strategy (REMS) Program
SUBOXONE Film, SUBOXONE Tablets, and SUBUTEX Tablets Risk Evaluation and Mitigation Strategy (REMS) Program Office-Based Buprenorphine Therapy for Opioid Dependence: Important Information for Prescribers
Capital BlueCross Open/Closed Formulary Update (1 st Quarter 2017)
Capital BlueCross Open/Closed Formulary Update (1 st Quarter 2017) The Capital BlueCross formulary is a reference list of prescription drugs that contains a wide range of generic and brand drugs that have
Substance Use Disorders (SUDs) and Medication Assisted Treatment (MAT) for Opiates
Substance Use Disorders (SUDs) and Medication Assisted Treatment (MAT) for Opiates What is MAT? Medication Assisted Treatment (MAT) is the use of medications, in addition to counseling, cognitive behavioral
Opioid Prescription and Illicit Drug Overdoses: On the Rise
Opioid Prescription and Illicit Drug Overdoses: On the Rise Cindy Haynes, MSA-PA, CHES Chronic Pain Program Coordinator Northern Piedmont Community Care Duke Division of Community Health Objectives Define
Revised 9/30/2016. Primary Care Provider Pain Management Toolkit
Revised 9/30/2016 Primary Care Provider Pain Management Toolkit TABLE OF CONTENTS 1. INTRODUCTION Page 1 2. NON-OPIOID SERVICES &TREATMENTS FOR CHRONIC PAIN Page 2 2.1 Medical Services Page 2 2.2 Behavioral
Proposed Revision to Med (i)
Proposed Revision to Med 501.02 (i) I. Purpose This rule has been adopted to enable the Board to best protect public health and safety while providing a framework for licensees to effectively treat and
Opioid Harm Reduction
Opioid Harm Reduction Lucas G. Hill, PharmD Clinical Assistant Professor, The University of Texas at Austin College of Pharmacy Clinical Pharmacist, CommUnityCare FQHCs Director, Operation Naloxone Mark
Medication-Assisted Treatment. What Is It and Why Do We Use It?
Medication-Assisted Treatment What Is It and Why Do We Use It? What is addiction, really? o The four C s of addiction: Craving. Loss of Control of amount or frequency of use. Compulsion to use. Use despite
BUPRENORPHINE and Office-Based Treatment of Opioid Use Disorder
BUPRENORPHINE and Office-Based Treatment of Opioid Use Disorder Stephen A. Wyatt, DO Anthony Dekker, DO William Morrone, DO Funding for this initiative was made possible (in part) by Providers Clinical
Opioid Step Policy. Description. Section: Prescription Drugs Effective Date: April 1, 2018
Federal Employee Program 1310 G Street, N.W. Washington, D.C. 20005 202.942.1000 Fax 202.942.1125 Subject: Opioid Step Policy Page: 1 of 6 Last Review Date: March 16, 2018 Opioid Step Policy Description
STEP THERAPY WITH QUANTITY LIMIT AND POST LIMIT PRIOR AUTHORIZATION CRITERIA. AVINZA (morphine extended-release capsules)
Carelirst. +.V Family of health care plans cvs caremarktm STEP THERAPY WITH QUANTITY LIMIT AND POST LIMIT PRIOR AUTHORIZATION CRITERIA DRUG CLASS EXTENDED-RELEASE OPIOID ANALGESICS BRAND NAME* (generic)
Percocet 10 without acetaminophen
Percocet 10 without acetaminophen Gogamz Menu Best Deals percocet without the acetaminophen. Low Cost. Pill Shop, Cheap Prices. Free samples for all orders. percocet without the acetaminophen. Learn about
An overview of Medication Assisted Treatment (MAT) and acute pain management on MAT
An overview of Medication Assisted Treatment (MAT) and acute pain management on MAT Goals of Discussion Recognize opioid use disorder (OUD) Discuss the pharmacology of medication assisted treatments (MAT)
The Future of Prevention: Addressing the Prescription Drug Abuse and the Opioid/Heroin Epidemic in our Country
Integrating Primary and Behavioral Health Care Through the Lens of Prevention July 14, 2016 New Orleans, Louisiana The Future of Prevention: Addressing the Prescription Drug Abuse and the Opioid/Heroin
ABA. The American Board of Anesthesiology. Media Kit
ABA The American Board of Anesthesiology Media Kit ABOUT THE ABA The American Board of Anesthesiology (ABA) is a nonprofit organization whose mission is to advance the highest standards of the practice
Subject: Pain Management (Page 1 of 7)
Subject: Pain Management (Page 1 of 7) Objectives: Managing pain and restoring function are basic goals in helping a patient with chronic non-cancer pain. Federal and state guidelines require that all
Pequot Health Care Opioid Analgesic Quantity Program*
Pequot Health Care 1 Annie George Drive Mashantucket, CT 06338 Phone: 1-888-779-6638 Fax: 1-860-396-6494 Pequot Health Care Opioid Analgesic Quantity Program* Effective January 2018 *Quantity Program limits