INDIANAPOLIS -- Indiana physicians will be advised to cut back in prescribing opioids to patients experiencing acute pain, based on guidelines announced Wednesday by three medical agencies.
Doctors will also be asked to follow a set of checkpoints that include a primary look at using non-pharmacologic therapy. The guidelines were developed jointly by the Indiana Hospital Association, Indiana State Medical Association and Indiana State Department of Health.
Death by drug overdoses in Indiana have risen 500 percent since 1999, according to Julie Reed, executive vice president of the Indiana State Medical Association (ISMA).
“Unintended opioid overdose has become one of the leading causes of injury-related deaths in Indiana over this past decade.,” said Dr. Kristina Box, commissioner of the Indiana State Department of Health. “In fact, you’re more likely to die of a drug overdose than a car crash.”
The guidelines geared to outpatient management encourage healthcare providers to diagnose a patient with pain, develop a treatment plan, and look for a non-opioid treatment. The guidelines acknowledge that every patient has a different need and may not apply to some patients.
The guidelines, however, take into account recent Indiana law that limits opioid prescribers to a seven-day supply to patients under 18 or to adults receiving opioids for the first time.
Since that law took effect July 1, there has been a reduction in opioid prescriptions by 100,000, said Dr. John McGoff, president of the ISMA.
“These are what we are recommending as best practice and hoping that physicians will abide by those,” McGoff said.
But the guidelines could be cited if the Indiana Attorney General’s office investigates a complaint against a healthcare provider.
The new guidelines follow similar ones issued in opioid prescribing at emergency departments and on chronic pain management, according to Dr. Nancy Kennedy, chief medical officer of the Dearborn County Hospital.
Acute pain is described as a pain that fades with healing, is related to tissue damage but significantly alter’s a patient typical functions. If it still persists at 12 weeks, it is considered chronic pain. Examples are the pain associated with removal of a wisdom tooth or after undergoing surgery.