The California Department of Public Health (CDPH) Statewide Opioid Safety (SOS) Workgroup has published a resource sheet to help physicians improve patients’ pain management, while avoiding opioid misuse and addiction. The Opioid Prescribers Resource Sheet contains information and resources to help physicians treating patients that may be opioid dependent or struggling with possible substance addiction symptoms.

According to CDPH, one of the most challenging situations reported by prescribers is how to respond to patients already on high doses of opioids (> 90 MMEs) or with possible addiction symptoms. Recent concerns about opioid misuse and abuse has led to some misinterpretation resulting in abruptly terminating the use of opioids, which can cause health risks for patients.

The California Medical Association (CMA) also has concerns related to the impact of various policies by payors, retail pharmacies and policymakers that restrict opioid dosage and duration as the primary lever in determining access to pain treatment for patients across a variety of settings. Coupled with a lack of coverage for conjunctive or alternative nonpharmacologic and nonopioid therapies, many patients are unable to access effective and legitimate pain care in a timely manner.

CDPH stresses that some pain management situations may involve the use of opioid medications if alternative approaches are not available or effective. The Opioid Prescribers Resource Sheet contains resources to help physicians with these critical treatment issues:

• Considering all pain management options before starting patients on opioids.
• Recognizing when and understand how to taper patients at risk.
• Offering medication assisted treatment (MAT) to your patients.
• Providing patient referrals to MAT and addiction recovery programs.

Additional resources are available on the CMA safe prescribing resource page. The page includes the most current information and resources on prescribing controlled substances safely and effectively to relieve pain, while simultaneously reducing the risk of prescription medication misuse, addiction and overdose. You will also find two CMA white papers on prescribing opioids, links to CMA’s health law library resources on the topic, a listing of continuing medical education courses and webinars on pain management and safe prescribing, and more.