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Oregon Health Authority

Opioids: Resources for Health Care Professionals and CCOs

OHA Opioid Initiative

The Oregon Health Authority Opioid Initiative brings statewide partners and communities together to reduce deaths, non-fatal overdoses, and harms to Oregonians from prescription opioids, while expanding use of non-opioid pain care.

Prescribing Guidelines  Data Dashboard  Opioid Initiative: Overview for Medical Community


Primary Goals

1. Reduce risks to patients by making pain treatment safer and more effective, emphasizing non-opioid and non-pharmacological treatment.
2. Reduce harms to people taking opioids and support recovery from substance use disorders by making naloxone rescue and medication-assisted treatment (MAT) more accessible and affordable.
3. Protect the community by reducing the number of pills in circulation through implementation of safe opioid prescribing, storage, and disposal practices.
4. Optimize outcomes by making state and local data available for monitoring, evaluating, and informing policies and targeted interventions.

OHA convened workgroups from 2016-2019, all aimed at reducing prescription opioid misuse and overdose. These significant steps forward include:

  • approval of statewide prescribing guidelines by a work group of statewide providers;
  • chronic-use opioid reduction strategies with the CCO statewide performance improvement project;
  • naloxone availability;
  • increase in medication-assisted treatment;
  • coverage of non-opioid therapies for pain and prescribing limitation policies;
  • community interventions in high-burden regions;
  • development of prescribing guidelines for healthcare providers and dentists;
  • development of implementation strategies for healthcare quality improvement; and 
  • ongoing surveillance of controlled substance prescribing and drug overdose outcomes (calculated by hospitalizations and deaths).

A data dashboard is available with state and county statistics for opioid-related health outcomes and prescribing metrics.


Strategies to Reduce Risky Prescribing

OHA recommends the following strategies to reduce high-risk opioid prescribing:

  • Use opioid prescribing guidelines for pain management and in emergency departments.
  • Learn techniques to help patients manage chronic pain by taking the Oregon Pain Management Commission education course for health care professionals.
  • Refer patients to the Oregon Pain Guidance patient pain education toolkit to help improve the impact of chronic pain. 
  • Use the Oregon Prescription Drug Monitoring Program to assess and manage patient prescriptions.
  • Provide coverage for non-opioid chronic non-cancer pain treatment therapies.
  • Increase the number of providers who are certified to provide medication for opioid use disorder (MOUD) services, in conjunction with local substance use treatment programs.

Task Forces for Opioid Prescribing and Tapering Guidelines

The Oregon Health Authority gathered experts from across the state to develop clinical guidelines for opioid prescribing to improve patient safety, spread best practices, and address the need for compassionate care. 

In 2016, Oregon’s Opioid Prescribing Guidelines Task Force approved adoption of Oregon-specific prescribing guidelines for chronic pain. Oregon based these guidelines on the CDC Guideline for Prescribing Opioids for Chronic Pain. Through similar collaborations, Oregon developed guidelines to address opioid prescribing for, acute pain, dentists and pregnant women (see below).  

OHA convened experts on the 2019 Oregon Opioid Taper Guidelines Task Force. The resulting guidelines from this task force supplement the Opioid Prescribing Guidelines for Chronic Pain to help patients and prescribers approach opioid tapering with best practices in mind. 


Medication for Opioid Use Disorder (MOUD)

MOUD combines behavioral therapy with medications (such as buprenorphine, methadone and naltrexone) and can stabilize patients with opioid use disorder and improve social functioning.

MOUD is considered to be the gold standard for the treatment of opioid use disorder. MOUD has been shown to be a cost-effective treatment strategy with benefits to both patients and health care systems. Patients receiving MOUD services have consistently better treatment outcomes, less illicit drug use, lower rates of infectious disease, and overall lower utilization of emergency departments.

MOUD can be delivered in several ways:

OHA is working to:

  • Improve access to MOUD services for patients throughout the state;
  • Educate partners and stakeholders on the value of increased MOUD utilization, and partnering on innovative ways to serve Oregon's opioid dependent population; and
  • Increase the number of buprenorphine waivered physicians in practice in Oregon.

Prescribing Guidelines and Resources

TOPIC

SOURCE

Prescribing Guidelines: Healthcare Providers

Oregon Acute Opioid Prescribing Guidelines (pdf)
2018 Oregon Opioid Prescribing Guidelines Workgroup
Opioid Prescribing Guidelines (pdf)
2016 Oregon Opioid Prescribing Guidelines Task Force (Updated July 2024)

Pregnancy and Opioids

2018 Oregon Pregnancy and Opioids Workgroup

CDC Guideline for Prescribing Opioids for Chronic Pain and Guideline Resources

CDC

Opioids and Pregnancy / Neonatal Abstinence Syndrome (NAS)

See "Pregnancy and Opioids" under Prescribing Guidelines above.

Committee Opinion: Opioid Use and Opioid Use Disorder in Pregnancy ACOG
MMWR: Opioid Prescription Claims Among Women of Reproductive Age, U.S. 2008-2012 CDC
Clinical Report: Neonatal Drug Withdrawal (pdf) AAP
Webinar - Perinatal Quality Collaborative: Neonatal Abstinence Syndrome, 2013 CDC
Training on Opioid Prescribing

Applying CDC's Guideline for Prescribing Opioids

CDC
SAFE Opioid Prescribing Training (Strategies, Assessment, Fundamentals, Education) ACOG

Oregon Plans and Reports

Reducing Opioid Overdose, Misuse and Dependency: Guide for CCOs (pdf) OHA
CD Summary: Prescribing Opioids for Chronic Pain, Guidelines are one piece of the puzzle (pdf) OHA

Oregon Health Plan (OHP) Resources

OHP Fee-for service coverage of back and spine pain diagnosis and treatment (Word) OHA
Resources for tapering OHP members with chronic pain off prescription opioids (pdf) OHA

Medication-Assisted Treatment (MAT) / Medication for Opioid Use Disorder (MOUD)

SAMHSA's MAT website SAMHSA

NW Addiction Technology Transfer Center's website

NW-ATTC
Taking Action to Address Opioid Misuse ATTC
Providers' Clinical Support System for MAT PCSS
Providers' Clinical Support System for Opioid Therapies PCSS
American Association for the Treatment of Opioid Dependence AATOD
A quick introduction to medications for opioid use disorder (MOUD)
OHA

SAMHSA Collaborates with Federal Partners to Understand Buprenorphine Availability

SAMHSA

Naloxone / Opioid Overdose

Naloxone Training Protocol OHA
Naloxone Rescue for Opioid Overdose OHA
SAMHSA Opioid Overdose Prevention Toolkit SAMHSA

National Reports and Data

Vital Signs: Prescription Painkiller Overdoses in the U.S. (pdf) CDC
Opioid Overdose: Data Overview CDC
The Prescription Opioid Epidemic: An Evidence-Based Approach (pdf) Johns Hopkins Bloomberg School of Public Health

Related Websites

Oregon Pain Guidance website Oregon Pain Guidance Group
American Medical Association: Reversing the Opioid Epidemic AMA
Surgeon General's "Turn the Tide Rx" campaign website

Surgeon General of the United States
Oregon Pain Management Commission education course
OR Pain Management Commission

Acronyms

AATOD: American Association for the Treatment of Opioid Dependence

ACEP: American College of Emergency Physicians

ACOG: American College of Obstetricians and Gynecologists

AMA: American Medical Association

ATTC: Addiction Technology Transfer Center

CDC: Centers for Disease Control and Prevention

OHA: Oregon Health Authority

PCSS: Providers' Clinical Support System

SAMHSA: Substance Abuse and Mental Health Services Administration