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OHA to convene Oregon Opioid Taper Guidelines Task Force

Applications due by Feb. 1

January 14, 2019

Oregon Health Authority is seeking applicants to serve on a task force that will develop clinical guidelines on opioid tapering. These guidelines will build on the work of previous task forces that developed statewide opioid guidelines for chronic pain, acute pain, dentists and pregnant women. The existing guidelines have been built on available evidence, other federal and state guidelines, expert opinion, and public comment. Their purpose is to guide clinical decisions and encourage safe and compassionate prescribing and pain treatment statewide.

The Oregon Opioid Taper Guidelines Task Force should represent diverse perspectives and experiences with long-term opioids and tapering, including community members. Task force members would serve as appointees of OHA Director Patrick Allen. Those who wish to serve on the board should apply by 5 p.m. Friday, Feb. 1, 2019. Appointment decisions are expected to be announced in February. The task force will meet publicly once a month from March to August. The application and more details on the process are available on the OHA website.

OHA’s efforts to change the conversation and promote evidence-based pain treatment are contributing to significant progress in the opioid epidemic. Oregon’s prescription opioid-related deaths have decreased by 45 percent since 2006 and the rate of opioid prescription fills decreased by 28 percent since 2015.

"In addition to preventing unnecessary and risky introduction of opioids to new patients, chronic pain patients currently receiving long-term opioids need compassionate, skilled care to taper to safer doses," said Katrina Hedberg, MD, state health officer and epidemiologist at OHA. "However, there are few resources and evidence related to tapering that clinicians can look to for guidance. We hope bringing together experts and community members around the state will help us develop a useful framework that promotes trusting dialogue, competent care and patient safety."

As part of Oregon’s broader efforts to reduce and prevent opioid-related harms, OHA has been expanding Oregon Health Plan coverage for a wide range of evidence-based pain management services. In July 2016 coverage went into effect for the treatment of back pain with services such as chiropractic manipulation, physical and occupational therapy, and acupuncture. This effort was coupled with reductions in opioid coverage for back pain to improve patient safety and function. OHA is considering a similar coverage update for several other chronic pain conditions that are not currently covered by OHP, including fibromyalgia. The topic is on the Jan. 17 meeting agenda of the Health Evidence Review Commission’s Value-based Benefits Subcommittee (VbBS).

"During the public deliberations of potentially adding coverage for certain chronic pain patients, while restricting access to opioids, it became clear that we needed to take a step back to fully consider the unintentional consequences of tapering patients too quickly or without adequate individualized support," said Dana Hargunani, MD, chief medical officer at OHA. "We appreciate the many patients, advocates and health experts who spoke up about their concerns."

While the evidence of harms related to long-term opioid use have been clear, much less is known about the potential risks of tapering. Patients and clinicians have advocated for personalized care with close attention to patients’ behavioral health and quality of life. The taper guidelines task force members will meet in public in Portland. A conference line will be available for task force and community members who are unable to attend in person.

More information:

Opioid prescribing guidelines

Jan. 17 VbBS meeting agenda and materials



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