Improving Opioid Prescribing to Limit Potential for Non-­Medical Opioid Use

Prescription drug abuse is a significant problem, and is the fastest growing [drug] problem in the United States. More individuals use prescription drugs than heroin and cocaine combined. The increase in non-medical opioid use is directly correlate with the rate of opioid overdose death, which has increased 400% since the year 2000. The distribution and use of opioids for non-medical use must be controlled to reduce the number of prescription opioid deaths. Individuals are most likely to receive medications from a licensed healthcare provider with prescriptive authority. There are two means by which this occurs: dishonesty obtaining a prescription for exaggerated or malingering symptoms; from excess supply of opioids from a friend or family member. This project aims to address the two main avenues by which individuals obtain opioids for non-medical use: dishonestly from providers and from family or friends with excess opioids from legitimate prescriptions. In an attempt to identify individuals seeking care to obtain opiods for non-medical use, a drug-seeking behavior mnemonic is developed. This is an objective checklist providers can consider when evaluating a patient for potential opioid prescription. If the patient triggers any of the points on the mnemonic, the provider can decide to take the next steps in evaluating for non-medical opioid use, such as urine drug screen or utilizing state or insurance databases. To address excess opioid medication, the second primary source of opioids for non-medical use, opioid prescribing recommendations are provided. The aim of these recommendations is to treat pain for the expected duration of the acute episode with emphasis on follow-up for patients with pain that is not resolving. Both the mnemonic and prescribing recommendations will be organized into a manuscript and poster presentation. These will both be prepared for review to peer organizations for publication and presentation, respectively.