Goal: Engage health plans and health systems to ensure safe prescribing practices consistent with the CDC Guidelines for Prescribing Opioids for Chronic Pain, in support of the Surgeon General's Call to Action (www.turnthetiderx.org).
Safe Med LA plans to enlist all health plans and major provider groups in Los Angeles County to use the following toolkit designed to support this work:
Goal: Engage all ED's and UC's in Los Angeles County to adopt and implement the American Academy of Emergency Medicine (AAEM) Opioid Prescribing Guidelines.
Currently, all ED's and over 80 UC's through Los Angeles County are using the AAEM Guidelines and the following toolkit to support this work:
Working Together to Reduce Prescription Drug Abuse and Overdose Deaths
Use Non-Opioid Therapies
Use non-pharmacologic therapies (such as exercise, physical therapy, and cognitive behavioral therapy) and non-opioid pharmacologic therapies (such as anti-inflammatories) for chronic pain. Don’t use opioids routinely for chronic non-cancer pain. When opioids are used, combine them with non-pharmacologic or non-opioid pharmacologic therapy, as appropriate, to optimize benefits.
Start Low and Go Slow
When opioids are used, prescribe the lowest possible effective dose and start with immediate-release opioids instead of extended-release/long-acting opioids. Only provide the quantity needed for the expected duration of pain. For moderate to severe acute pain, avoid more than 3 - 7 day supply. Avoid > 90 MME/day.
Regularly monitor patients to make sure opioids are improving pain and function without causing harm. If benefits do not outweigh harms, optimize other therapies and work with patients to taper or reduce dosage and discontinue, if appropriate.