Across the nation, health care providers are facing a serious dilemma: how to prescribe controlled substances safely and effectively to relieve pain, while simultaneously reducing the risk of prescription medication misuse, addiction, and overdose. 

The California Medical Association (CMA) has been supportive of efforts to address the complicated issues related to prescription opioid misuse and overdose, and CMA has supported a well-balanced approach to opioid prescribing and treatment that considers the unique needs of individual patients.

In June 2013, CMA  released a policy paper “Opioid Analgesics in California: Relieving Pain, Preventing Misuse, Finding Balance,” which included several recommendations such as establishing and funding a range of tools to improve patient safety, including California’s prescription drug monitoring program and drug take-back and substance abuse treatment programs. In March 2014, CMA also released a white paper providing clinical recommendations based upon a review of current literature, existing clinical guidelines and expert opinion. 

CMA also joined with the California Chapter of the American College of Emergency Physicians to promote a statewide safe prescribing program for patients seen in emergency departments or urgent care facilities. The goal of the program – motivated by the desire to reduce prescription drug abuse and drug diversion – is better patient care, safer prescribing and fewer unmet expectations.

Although much work remains to be done, California is seeing positive results – a testament to the comprehensive statewide and local strategy, and role of the medical and public health community. To that end, California experience two consecutive years of decreases in prescription-related opioid deaths while surpassing the national average for prescription decreases between 2014-2017.

(See also: CURES)