MAT Waiver Training
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Date: Thursday, November 12, 2020
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Time: 8 a.m. - 12:30 p.m. PST
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Location: Virtual
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Tuition: No Cost
Pain Management Updates
ATTENTION: CDC Advises Against Misapplication of the Guideline for Prescribing Opioids for Chronic Pain
Authors of the 2016 CDC Guideline for Prescribing Opioids for Chronic Pain are advising against misapplication of the guideline that can risk patient health and safety, raising awareness of the following issues:
- Misapplication of recommendations to populations outside of the Guideline's scope. The Guideline is intended for primary care clinicians treating chronic pain for patients 18 and older. Examples of misapplication include applying the Guideline to patients in active cancer treatment, patients experiencing acute sickle cell crises, or patients experiencing post-surgical pain.
- Misapplication of the Guideline's dosage recommendation that results in hard limits or “cutting off" opioids. The Guideline states, “When opioids are started, clinicians should prescribe the lowest effective dosage. Clinicians should… avoid increasing dosage to ≥90 MME/day or carefully justify a decision to titrate dosage to ≥90 MME/day." The recommendation statement does not suggest discontinuation of opioids already prescribed at higher dosages.
- The Guideline does not support abrupt tapering or sudden discontinuation of opioids. These practices can result in severe opioid withdrawal symptoms including pain and psychological distress, and some patients might seek other sources of opioids. In addition, policies that mandate hard limits conflict with the Guideline's emphasis on individualized assessment of the benefits and risks of opioids given the specific circumstances and unique needs of each patient.
- Misapplication of the Guideline's dosage recommendation to patients receiving or starting medication-assisted treatment for opioid use disorder. The Guideline's recommendation about dosage applies to use of opioids in the management of chronic pain, not to the use of medication-assisted treatment for opioid use disorder. The Guideline strongly recommends offering medication-assisted treatment for patients with opioid use disorder.
More information about the CDC Guideline for Prescribing Opioids for Chronic Pain and how appropriately apply it to patient care, visit the CDC's website.
ATTENTION: In July 2020, the Food and Drug Administration provided guidance directing health care professionals to discuss naloxone, a potentially life-saving medication that can reverse drug overdoses, with all patients when prescribing opioid pain relievers or medicines to treat opioid use disorder. See the
FDA's website for additional information.
The
Oregon Pain Guidance website provides pain management guidance and tools for healthcare professionals as well as patients and families.
The Federation of State Medical Boards'
Opioids and Pain Management webpage offers numerous resources on state, federal, and FSMB opioid policies.
Note: The National Transportation Safety Board reminds health care providers to discuss with patients the effects that their medical conditions and medications may have on their ability to safely operate a vehicle in any mode of transportation.
Medication Assisted Treatment (MAT) for Opioid Addiction – Physician Assistants and Nurse Practitioners are now included among the healthcare professionals who may provide MAT for opioid addiction. More information is available on the
Substance Abuse and Mental Health Services Administration (SAMHSA) website. All MAT providers must complete training and be granted a waiver by the DEA. The required 24-hour continuing education training is free and available through the
Providers' Clinical Support System.
SAMHSA began certifying PAs and NPs on February 21, 2017. As of August 28, 2018, there were 687 certified PAs nationwide and 2,471 certified NPs. SAMHSA says, "More buprenorphine prescribers are needed to combat the opioid crisis and treat substance use disorders, particularly in rural areas."