Articles the Physician-Patient Alliance for Health & Safety (PPAHS) have been reading the week of June 25, 2018 focus on 3 efforts to help stop the opioid epidemic.
Effort #1 – Does Government Legislation Address the Opioid Epidemic?
The House of Representatives recently passed what has been called the “most expansive legislation” to address the opioid epidemic. According to CNN, the key provision would allow Medicaid to pay for certain treatments for mental illness.
Although mental illness needs to be treated, all of the deaths that the Physician-Patient Alliance for Health & Safety (PPAHS) has reported on are in no way related to mental illness – see for example, these patient stories that PPAHS shared at the inaugural meeting of the National Coalition to Promote Continuous Monitoring of Patients on Opioids.
Do you think government legislation addresses the opioid epidemic?Do you think government legislation addresses the #opioidepidemic? Click To Tweet
Effort #2 – Does Concurrent Use of Opioid Analgesics With Gabapentinoids and Other CNS Depressants Pose a Patient Safety Risk?
Douglas C. Throckmorton, MD, who is deputy center director for Regulatory Programs in the FDA’s Center for Drug Evaluation and Research, writes about FDA concerns regarding concurrent use of opioids and gabapentinoids and other CNS depressants:
“The FDA is investigating the potential consequences of these increases in gabapentinoid prescribing because concerns also have been raised about the possible misuse and abuse of these medicines.”
PPAHS has previously reported on benzodiazepines and opioids being a deadly combination and we recently issued this position statement of using benzodiazepines and opioids, “Patients Receiving Benzodiazepines, in Combination with Opioid Analgesics, May Suffer from Respiratory Compromise and Death” saying:
“Opioids are the most prescribed class of medication in hospitals, leading it to be one of the most common class of medication to cause adverse patient events.
“One of the commonly overlooked complications to safe opioid administration is failing to account for the additive sedation effects of non-opioid medication.”
Looking at the concurrent use of opioid analgesics with gabapentinoids and other CNS depressants would seem to be warranted. Do you agree?Does Concurrent Use of #Opioid Analgesics With #Gabapentinoids and Other CNS Depressants Pose a #PatientSafety Risk? Click To Tweet
Effort #3 – Can Ketamine Help Stop the Opioid Epidemic?
Ketamine is used by anaesthetists and pain physicians to reduce opioid medication and may be an effective agent for managing opioid withdrawal. However, to-date, there has been little formal guidance for clinicians on using ketamine.
To help provide guidance, the American Society of Regional Anesthesia and Pain Medicine, the American Academy of Pain Medicine, and the American Society of Anesthesiologists approved consensus guidelines regarding the use of ketamine for the management of acute pain. The guidance concludes:
ketamine infusions were indicated and should be considered for painful surgeries and for surgeries in which the patient was opioid tolerant or opioid dependent.
Do you think that guidance on ketamine use by the American Society of Regional Anesthesia and Pain Medicine, the American Academy of Pain Medicine, and the American Society of Anesthesiologists is useful?Can #Ketamine Help Stop the #OpioidEpidemic? Click To Tweet