Brandeis University Study Shows Few Opioid Prescribers Warned Patients of Risk of Addiction Before State Requirement

Founder of Prevent Opioid Abuse says findings take on a new importance as COVID-19 is predicted to up substance abuse disorder

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April 15, 2020 – A New Jersey law requiring conversations between prescribers and patients to discuss risks of addiction before an opioid-based pain reliever is prescribed, resulted in a more than fourfold increase in the percentage of doctors warning patients about the risks of addiction and a significant drop in patients started on opioids. The study was conducted by Dr. Andrew Kolodny, medical director of opioid policy research at Brandeis University’s Heller School for Social Policy and Management. Dr. Kolodny presented the findings today at the Rx Drug Abuse & Heroin Summit, which was held virtually, rather than at its original Nashville location.

The Patient Opioid Notification Act requires that medical practitioners discuss the addictive potential of opioid-based painkillers with their patients – and parents of minor patients – as well as discuss, when appropriate, safer non-opioid pain relief alternatives. Versions of this legislation have been adopted in 17 states. New Jersey was selected for the study because it was the first state to implement the law.

Representative David Trone (D-MD) will soon introduce national legislation based on these state laws that will require all patients and parents in the nation to be armed with this lifesaving information.

“With the COVID-19 pandemic delaying many elective medical and dental surgeries and procedures, we know that there will be an uptick in opioid prescribing in the future,” explained,  Elaine Pozycki, founder of Prevent Opioid Abuse. “At this critical time, it is imperative that patients be provided this information at the time their opioid is prescribed.

Major Findings

  • The number of patients prescribed opioids for acute pain decreased significantly after the law went into effect. The aspect of the law likely to have been responsible for this change was the mandatory warning about the risk of addiction. In the month after the law was implemented nearly 5000 fewer patients were started on opioids.
  • The number of clinicians who prescribed opioids for acute pain dropped by more than 1000 after the law went into effect.   
  • Nearly all prescribers (97.5%) were aware of the new opioid prescribing rules. 
  • Prior to enactment, only 18% of the participants warned patients about the risk of opioid addiction when prescribing opioids.  After enactment, 95% routinely warned patients about the risk of addiction.

What people are saying about the Study

Dr. Andrew Kolodny said, “These findings show that very few opioid prescribers were warning patients about the risk of addiction before New Jersey required them to do so.”

“Requiring prescribers to talk to their patients about the risk of addiction right before an opioid is first prescribed makes sense now more than ever, especially with the anticipated surge of addiction anticipated because of the COVID-19 pandemic,” said Congressman David Trone. “I will soon introduce national legislation that aligns with what we learned from this study and works to prevent the opioid crisis in this country from getting worse.”

Background:

Brandeis University researchers analyzed data from the New Jersey Prescription Drug Monitoring Program and conducted structured interviews with New Jersey clinicians.

The Patient Opioid Notification Act is now law in New Jersey, Rhode Island, Maryland, Nevada, Ohio, Oklahoma, West Virginia, Utah, Washington, Louisiana, Missouri, and Nebraska for all patients; in California, Connecticut, Michigan, Pennsylvania and South Carolina, it covers minors and their parents.

Prevent Opioid Abuse is a national organization working to educate patients and parents about the risks of opioid-based painkillers and the availability of non-opioid alternatives.


Drug overdose deaths in 2020 hit highest number ever recorded, CDC data shows

From cnn.com:
Drug overdose deaths rose by close to 30% in the United States in 2020, hitting the highest number ever recorded, the US Centers for Disease Control and Prevention reported Wednesday.
More than 93,000 people died from drug overdoses in 2020, according to provisional data released by the CDC’s National Center for Health Statistics. That’s a 29.4% increase from the 72,151 deaths projected for 2019.”

Read complete article here.


Doctors Who Stay Current on Medical Knowledge Less Likely to Overprescribe Opioids

From Addiction Professional:

“Physicians who stay current on medical knowledge are less likely to overprescribe opioids for back pain, according to a study published last week by researchers from Harvard University and the American Board of Internal Medicine.

The study, published July 1 by JAMA Open, looked at knowledge scores 10,246 mid-career general internists on the ABIM Maintenance of Certification Exam, as well as opioid prescribing practices between 2009 and 2017. During that period overall, opioids were prescribed for 21.6% of 55,387 office visits for new onset lower back pain. With new information about the scope of the opioid epidemic began to emerge from 2015 to 2017, prescribing guidelines were revised.”
Read complete article here.

https://www.hmpgloballearningnetwork.com/site/ap/news/doctors-who-stay-current-medical-knowledge-less-likely-overprescribe-opioids


Text Message Program Shows 60 Percent of Opioid Tablets Unused After Common Procedures

A Penn Medicine new study of how text messaging could inform opioid prescribing practices showed that 60 percent of opioids are left over after orthopaedic and urologic procedures
March 25, 2021

PHILADELPHIA— More than half of the opioid tablets prescribed for patients who underwent orthopaedic or urologic procedures went unused in a new study by researchers at the Perelman School of Medicine at the University of Pennsylvania. Using an automated text messaging system that regularly checked in with patients on their pain and opioid use, the study also showed that most opioids are taken within the first few days following a procedure and may not be necessary to manage pain even just a week following a procedure. The study was published today in JAMA Network Open.

Read complete article here.


Rep. Trone Introduces Bipartisan Legislation to Help Prevent Opioid Addiction

FOR IMMEDIATE RELEASE

February 18, 2021

Contact: Hannah Muldavin, Hannah.Muldavin@mail.house.gov

Rep. Trone Introduces Bipartisan Legislation to Help Prevent Opioid Addiction

WASHINGTON — Today, U.S. Representative David Trone (D-MD), along with Reps. Guy Reschenthaler (R-PA), Teresa Leger Fernandez (D-NM), and David McKinley (R-WV), introduced the bipartisan Opioid Patients’ Right to Know Act to help prevent opioid addiction across the country.

According to the Centers for Disease Control and Prevention (CDC), health care providers dispensed over 153 million opioid prescriptions in 2019, and a recent study estimates that 1% to 4% of individuals who take prescription opioids develop opioid use disorder, putting their lives at risk. The Opioid Patients’ Right to Know Act would create a grant program to incentivize states to require prescribers to discuss the addictive qualities of the drugs with patients and inform them of alternative treatment options before prescribing them for acute pain.

“Opioid addiction is on the rise, made even worse by the COVID-19 pandemic, and we need to take steps to prevent it from happening in the first place,” said Rep. Trone, member of the Commission to Combat Synthetic Opioid Trafficking. “This bill will help ensure that patients have the knowledge to make informed decisions about what treatment option is right for them.”

“Too many lives have been cut short by the opioid crisis, which continues to wreak havoc on families and communities in southwestern Pennsylvania and throughout the country,” said Rep. Reschenthaler. “I’m proud to join with Representative Trone to introduce the bipartisan Opioid Patients’ Right to Know Act, which will increase awareness of opioids’ addictive qualities and encourage doctors to discuss non-opioid alternatives. I hope our colleagues join us in supporting this bill to empower patients and save lives.”

“Countless families across New Mexico and around the country have suffered through the pain of opioid addiction. In New Mexico, one-third of all drug overdose deaths involved prescription opioids. We rely on our health professionals to be clear and honest about treatment. This bill helps ensure these professionals make us fully aware of the risks of opioids before writing a prescription,” said Rep. Leger Fernández. “This bill puts a public health lens on the opioid epidemic and will bring us one step closer to beating it.”

“The opioid crisis continues to take the lives of tens of thousands of Americans across the nation and the pandemic has only exacerbated this epidemic,” said Rep. McKinley. “This bill strengthens communication between patients and prescribers to ensure patients have the information they need to make educated decisions. People need to know the true risks when considering options to manage their pain and understand there are alternatives to highly addictive opioids.”

“Every American has the right to be warned about the highly addictive qualities of opioids–and that there are effective non-opioid pain relief alternatives-and to receive this warning at the time it is most needed–right before an opioid is prescribed,” said Elaine Pozycki, the Founder of Prevent Opioid Abuse, a national organization working to educate patients and parents about the risks of opioid-based pain relievers and the availability of non-opioid alternatives. “The Opioid Patients’ Right to Know Act provides the incentives needed to persuade every state in the nation to adopt this proven prevention measure. I urge Congress to move speedily to adopt it.”

“We appreciate the efforts of Congressman Trone. His continued leadership on the opioid use crisis is sorely needed during these difficult times,” said Hon. Mary Bono, Co-Convenor of the Collaborative for Effective Prescription Opioid Policies (CEPOP).

“Voices for Non-Opioid Choices is dedicated to combatting the opioid epidemic by expanding access to and utilization of non-opioid options for acute pain management. We applaud Representatives Trone, McKinley, Leger Fernandez, and Reschenthaler for introducing The Opioids Patients’ Right to Know Act, which will help to ensure patients and providers are educated about opioids and learn about the non-opioid treatment options that may be available to them. We are hopeful this effort will help reduce the rates of chronic opioid use after surgery in America, and provide greater access to non-opioid options. We look forward to continuing to work with Congress to curb the opioid epidemic by providing parity in acute pain management,” said Chris Fox, Executive Director for Voices for Non-Opioid Choices.

Organizations supporting the Opioid Patients’ Right to Know Act include: Prevent Opioid Abuse (POA), Collaborative for Effective Prescription Opioid Policies (CEPOP), Mothers Against Prescription Drug Abuse (MAPDA), Partnership to End Addiction, Shatterproof, Addiction Policy Forum, FED UP!, Physicians for Responsible Opioid Prescribing (PROP), and Voices for Non-Opioid Choices.

To read bill text, click here

To read a bill summary, click here.

Congressman David Trone was elected to the House of Representatives in November 2018 to serve the 6th District of Maryland, which includes all or part of Montgomery, Frederick, Washington, Allegany, and Garrett Counties. Trone serves on the Appropriations, Veterans’ Affairs, and Joint Economic Committees in the 117th Congress and previously served on the Education and Labor and Foreign Affairs Committees. In Congress, Trone is fighting to make progress on issues that matter to Marylanders, including the opioid epidemic, criminal justice reform, and funding for medical research.

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