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Revised guidelines emanate from collaborative effort
Revised guidelines emanate from collaborative effort
KEY POINTS, RECOMMENDATIONS
KEY POINTS, RECOMMENDATIONS
- These guidelines do not have the force of law, but instead are intended to assist practitioners evaluate and make informed decisions about the safe prescribing and dispensing of opioids
- Collaboration with Mental and Behavioral Health
- Consideration of alternatives to opioids.
- Partnering with the the patient to develop a treatment plan, including functional goals and an exit strategy.
- Patient education, including the risks and benefits of opioid therapy, which is crucial prior to initiating therapy, before increasing the dosage and upon meeting the “bright line” safe prescribing thresholds
- Reduction in days of treatment for acute pain
- Assessment of patient functionality early and often.
- Frequent re-balancing of the risks and benefits of continued opioid therapy.
- Incorporation of three “bright line” safe prescribing thresholds upon which the prescriber should re-evaluate the patient and the effectiveness of the opioid treatment and employ risk mitigation strategies, including prescriptions for Naloxone, if opioid treatment is to continue:
- Dosage: 50 mme/day
- Formulation: Long-acting or extended-relief formulation
- Duration:
- 3-7 days for acute, non-traumatic or non-surgical pain
- 30 days for sub-acute pain
- 90 days for chronic, non-cancer pain
On March 16, 2018, the revised Guidelines for Prescribing and Dispensing Opioids were adopted by all six of Colorado’s prescribing and dispensing Boards- the Colorado Dental Board, the Colorado Medical Board, the State Board of Nursing, the State Board of Optometry, the Colorado Podiatry Board, and the State Board of Pharmacy, and endorsed by the State Board of Veterinary Medicine.
This revised Policy is a product of the collaboration between the seven Boards and a robust stakeholder engagement process. Stakeholder views, opinions and comments were essential in the revision of the 2014 Policy for Prescribing and Dispensing Opioids.
In honoring its commitment to evaluate the effectiveness and usefulness of the 2014 Policy as well as responding to any unintended consequences, the Boards embarked on an 18-month stakeholder engagement process in May 2016. The Boards solicited statewide stakeholder feedback, consulted with experts in the field of pain management, addiction and mental health, and reviewed current literature, policy, and guidelines related to the safe prescribing and dispensing of opioids for pain.
Taking this information, the Boards began the process of revising the 2014 Policy, and reviewed current literature, policy, and guidelines related to the safe prescribing and
dispensing of opioids for pain.
Taking this information, the Boards began the process of revising the 2014 Policy,
harmonizing its recommendations with current policy and, again, engaging stakeholders throughout the process. Beginning in January 2018, each Board reviewed and unanimously adopted, or endorsed in the case of the Colorado State Board of Veterinary Medicine, the revised Guidelines for Prescribing and Dispensing Opioids.
Moving forward, the Boards will continue to evaluate the Policy, incorporating new legislation and collaborating with other state agencies, researchers, practitioners, patients, the Colorado Consortium for Prescription Drug Abuse Prevention, and other stakeholders to identify and evaluate outcomes. The Boards remain committed to this Policy as a living document, reflective of the evolving science, technology, policy and law in their ongoing efforts to address Colorado’s opioid crisis.
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