Category: Opioid Safety

PPAHS and CUSPID Collaborate to Advance Pediatric Dental Patient Safety

Safe dental care for children is an important patient safety priority requiring evidence-based practices, appropriate monitoring, clinician education, and strong safety systems.

The Physician-Patient Alliance for Health & Safety (PPAHS) and CUSPID Institute™ are collaborating on complementary efforts to strengthen patient safety in pediatric dental care. PPAHS will focus on pediatric dental sedation safety, while CUSPID will advance patient safety in dentistry more broadly through education, safety culture, teamwork, systems improvement, and incident learning.

Pediatric Dental Safety

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Advancing Opioid Safety: New Evidence on Opioid-Induced Respiratory Depression

Opioids remain an essential component of pain management across surgical, procedural, and medical care. Yet alongside their benefits lies one of the most serious and potentially life-threatening risks: opioid-induced respiratory depression (OIRD). Despite decades of clinical use, OIRD continues to contribute to preventable patient harm across care settings.

A newly published peer-reviewed paper on OIRD, co-authored by a multidisciplinary group of clinicians and researchers — including Michael Wong, JD, Executive Director of the Physician-Patient Alliance for Health & Safety (PPAHS) — brings renewed attention to this critical patient safety challenge. The paper synthesizes current evidence on OIRD mechanisms, risk factors, and opportunities for improved prevention and response, reinforcing what many clinicians already recognize: respiratory depression is often predictable, frequently detectable, and too often recognized too late.

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Breaking the Stigma Around Dual Diagnosis

Editor’s Note: Breaking the stigma around dual diagnosis means seeing the full picture. Learn how truth, empathy, and integrated care lead to real recovery. In this thoughtful article, Pam Reiman discusses the situation when mental health problems and substance use collide.

By Pam Reiman, JD, LCSW, CAADC, CSAC (Executive Director at Bridging the Gaps, Inc.)

A person in a shirt with glasses looking stressed and leaning against the wall. The stigma around dual diagnosis shows up in quiet moments. A person with depression who drinks to cope may be told they “just need willpower.” Someone battling addiction might have their panic attacks dismissed as excuses. When the two conditions overlap, one often hides the other. The result is missed signs, unfair judgment, and delayed care.

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The Value of Non-Opioid Therapy in Reducing Opioid Harms

Editor’s Note: The role of non-opioid therapy in reducing opioid harms lies in offering safe alternatives for pain relief. This article asks you to explore your options.)

By Drew McLaughlin (Director of Business Development, Little Creek Lodge)

A patient and a doctor talking — Image credit: https://www.pexels.com/photo/man-in-white-dress-shirt-sitting-at-the-table-7578803/

Opioid misuse continues to cause widespread harm across communities. The rising use of prescription painkillers has led to long-term dependency and avoidable suffering. Families are left dealing with emotional strain, while healthcare providers face overwhelming challenges. Many individuals never intended to misuse opioids but found themselves trapped by ongoing reliance. The role of non-opioid therapy in reducing opioid harms is to offer a different approach—one that reduces risks and supports long-term wellness. These methods are gaining recognition for their ability to treat pain without creating new problems. The focus on reducing opioid harm is shifting the conversation toward more sustainable and supportive care models that prioritize health without introducing avoidable danger.

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I’ll Do What I Can: Speaking at the Ohio Consensus Conference on Opioid-Induced Respiratory Depression

By Michael W. Wong, JD (Executive Director, Physician-Patient Alliance for Health & Safety)

“I’ll do what I can”

I said to Cindy Abbiehl and her husband, Brian, “I’ll do what I can” after hearing that their daughter Amanda had died from opioid-induced respiratory depression.

Now, I realize that in social encounters, we often say things that we eventually do not follow through with. After all, we often say things like “we should do coffee one day” but don’t schedule time for coffee or “we should stay in touch” but don’t phone, email, or text to keep in touch.

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Our Love-Hate Relationship with Opioids: 3 Things Clinicians Can Do to Improve Patient Safety and the Quality of Patient Care

By Michael Wong, JD (Founder & Executive Director, Physician-Patient Alliance for Health & Safety)

Our Opioid Dichotomy

Opioids are something we love and hate, all at the same time. On the one hand, they are a great pain reliever and are often used to provide analgesia and supplement sedation during general anesthesia or monitored anesthesia care. On the other hand, opioids can be addictive and too much opioids can lead to opioid overdose and death. Justine Igwe (Nursing Student in Nigeria at the University of Nigeria Enugu Campus) recently wrote about opioids’ pain relief vs. addiction/overdose dichomotomy:

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The Need for Better Opioid Management

By Michael Wong, JD (Founder & Executive Director, Physician-Patient Alliance for Health & Safety)

Opioids Can be Deadly

To say that opioids can kill is perhaps to overstate the obvious. According to the National Institute on Drug Abuse, overdose deaths involving any opioid have steadily risen from 2010 to the present:

“Opioid-involved overdose deaths rose from 21,088 in 2010 to 47,600 in 2017 and remained steady in 2018 with 46,802 deaths. This was followed by a significant increase through 2020 to 68,630 overdose deaths.”

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Learning About Opioid-Induced Respiratory Depression from Logan’s Death

By Michael Wong, JD (Founder & Executive Director, Physician-Patient Alliance for Health & Safety)

An Introduction to Logan

In 2016, I had the immense pleasure of interviewing Pamela Parker, BSN, RN, CAPA about what happened to her 17-year-old son, Logan.

Pamela Parker has been a registered nurse for about 30 years. She is a recovery room nurse and, at the time of our interview, worked in the ambulatory procedure unit at a hospital in Indiana. In addition to providing patient care, Ms. Parker is a clinical educator and provides bereavement support. To help others with the loss of loved ones, she writes a blog “Hope for Grieving Mothers.”

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Sleep Apnea and Opioids is a Deadly Combination

By Michael Wong, JD (Founder/Executive Director, Physician-Patient Alliance for Health & Safety)

Sleep Apnea is a Common Sleep Disorder

Sleep apnea is a common sleep disorder. Sleep apnea patients have multiple extended pauses in breathing when asleep. This affects the oxygen supply to their bodies. As a result, approximately 20% wake up with headaches. Some suffer migraines. Still, most people think sleep apnea just disrupts sleep.

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Identifying Patients At Risk of Opioid-Induced Respiratory Depression

By Michael Wong, JD (Founder/Executive Director, Physician-Patient Alliance for Health & Safety)

Opioid-induced respiratory depression can lead to serious adverse events and even death, in hospitalized patients. In its Sentinel Event Alert #49, titled “Safe use of opioids in hospitals”, the Joint Commission stated, “While opioid use is generally safe for most patients, opioid analgesics may be associated with adverse effects, the most serious effect being respiratory depression, which is generally preceded by sedation.” The alert was retired as of February 2019 and is now addressed in the commission’s pain management standards for hospitals.

About half of in-hospital cardiorespiratory events occur on the general care floor. Often these events are fatal. Lars W. Andersen, MD (Department of Medicine, Regional Hospital Holstebro, Aarhus University & Department of Emergency Medicine, Beth Israel Deaconess Medical Center) and his colleagues concluded that acute respiratory events are common in inpatient wards in the US and are associated with a mortality rate of almost 40%.

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