MGMA: 6 principles for developing an opioid prescribing policy

An effective opioid prescribing policy entails clear communication, technology utilization and referral management, according to a Medical Group Management Association report.

MGMA analyzed survey data, in-depth interviews with 43 healthcare leaders and case studies to develop six principles for medical practices developing an opioid prescribing policy:

1. Don't make opioid therapy a first-line therapy for chronic pain. Opioid therapy can be used when the benefits are expected to outweigh the risks, but it should be combined with nonpharmacologic and nonopioid pharmacologic therapy, as appropriate.

2. Keep the care goals in mind. Include a plan for discontinuing opioid therapy in the treatment plans. This should occur as patients near their care goals.

3. Continuously educate patients about opioid therapy risks. The risks include addiction and misuse. Evaluate the benefits and harms linked to opioid use one to four weeks after therapy begins or after any increase in dosage.

4. Use proper dosage and duration. Immediate-release opioids at the lowest effective dosage are preferred for starting therapy.

5. Use state Prescription Drug Monitoring Program data before starting opioid therapy. Periodically refer to this data after the therapy begins. Patients should undergo urine drug testing of before beginning opioid therapy and undergo subsequent testing at least once a year after starting.

6. Be prepared to address misuse. Providers should be ready to offer or arrange treatment for patients with opioid use disorder. Treatment often includes buprenorphine or methadone along with behavioral therapy.

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