New Legislation Arms Advanced Practitioners in the Fight Against Opioids

More than 115 Americans die every day from opioid-related causes. The SUPPORT for Patients and Communities Act, which passed in the House last week, aims to stop that.

The U.S. opioid epidemic is a grave and serious crisis. Each day, more than 115 Americans die of opioid-related causes. A new “opioid package” passed in the U.S. House of Representatives last week, however, is taking aim at combatting the crisis.

H.R. 6, also known as the Substance Use Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities Act of 2018 is seen as a compromise between the House and Senate, which previously passed their own separate opioid abuse prevention packages. The SUPPORT for Patients and Communities Act, as it’s being called, is expected to be considered by the Senate in the coming days and then be sent to the President’s desk to be signed into law.

One of the major provisions of the SUPPORT for Patients and Communities Act applies directly to advanced practitioners:

“Enable clinical nurse specialists, certified nurse midwives, and certified registered nurse anesthetists to prescribe buprenorphine; and make the buprenorphine prescribing authority for physician assistants and nurse practitioners permanent. In addition, H.R. 6 will permit a waivered-practitioner to immediately start treating 100 patients at a time with buprenorphine (skipping the initial 30 patient cap) if the practitioner has board certification in addiction medicine or addiction psychiatry; or if practitioner provides MAT in a qualified practice setting. Medications, such as buprenorphine, in combination with counseling and behavioral therapies, provide a whole-patient approach to the treatment of opioid use disorder (H.R. 3692)”

Both the AANP and AAPA consider this legislation a win.

“With this agreement, Congress has reaffirmed the power of America’s 248,000 NPs to fight and win the battle against opioid addiction. The legislation permanently authorizes NPs to prescribe Medication-Assisted Treatments (MATs), further expanding patient access to these critical treatments—prescribed and managed by NPs,” AANP President Joyce Knestrick, Ph.D., C-FNP, APRN, FAANP said in a statement released last week.

Jonathan E. Sobel, DMSc, MBA, PA-C, DFAAPA, FAPACVS, president and chair of the AAPA Board of Directors, echoed that sentiment in his statement, saying, “AAPA applauds Congress for including this crucial provision as part of comprehensive legislation aimed at stemming the tide of the U.S. opioid epidemic.”

Disclaimer: The viewpoint expressed in this article is the opinion of the author and is not necessarily the viewpoint of the owners or employees at Healthcare Staffing Innovations, LLC.

Clinicians Who Learn Of A Patient’s Opioid Death Modestly Cut Back On Prescriptions

New research has found that physicians modestly reduced the volume of opioids they prescribed after being told one of their patients had died of an overdose.

Anna Gorman, Kaiser Health News

Physicians and other medical providers modestly reduced the volume of opioids they prescribed after being told one of their patients had died of an overdose, according to research published Thursday.

“You can hear a lot of statistics about the crisis,” said Jason Doctor, lead author of the study, published Thursday in the journal Science. “But it always feels like it is happening elsewhere if you are not aware of any deaths in your own practice.”

The research included more than 800 clinicians — doctors, nurse practitioners, physician assistants and dentists — comparing those who received a letter from the medical examiner about a patient’s death and those who didn’t. The ones who knew about the overdose death cut the overall volume of opioids they prescribed by almost 10 percent over three months, while those who didn’t know prescribed roughly the same amount as before.

The study shows that awareness and education can change prescribing behavior, said Doctor, a director at University of Southern California’s Schaeffer Center for Health Policy & Economics. The modest size of the reduction among those who were notified of a death suggests “that clinicians exercised greater caution with opioids rather than abandoning use,” according to the study.

The providers in the study who were informed about patients’ deaths were also 7 percent less likely to start new patients on opioids.

The letter did not blame providers for the deaths but showed that authorities were paying attention, according to the study.

“We were providing them with important information and also giving them a way to make things better by changing prescribing,” Doctor said. “Anyone who got the letter could continue to prescribe as much as they wanted, but we found that they didn’t. They became more judicious prescribers.”

Over 19,000 people died from prescription opioids in 2016, roughly double the number 14 years earlier, according to the National Institute on Drug Abuse. Most of that increase occurred from 2002 to 2011, and the numbers have been relatively stable since then, according to the NIDA.

Meanwhile, prescriptions of opioids are declining, and health officials are seeking ways to accelerate the trend.

The study did not measure whether the letters from the medical examiner or the changes in prescribing patterns had any effect on patient deaths.

Across the country, physicians have been accused of overprescribing opioids and have even faced charges related to patient overdose deaths. In an effort to better track prescribing patterns, states have started prescription drug monitoring databases.

The CDC recommends that providers avoid opioids if possible, but if they are necessary, they should start with the lowest effective dose.


Disclaimer: The viewpoint expressed in this article is the opinion of the author and is not necessarily the viewpoint of the owners or employees at Healthcare Staffing Innovations, LLC.

The Implications of the Opioid Lawsuits

Opioid manufacturers, drug distributors, and pharmacy chains continue to get hit with lawsuits alleging they fueled the nation’s opioid crisis through deceptive marketing and negligence.

from Axios

It’s not at all clear municipalities will win, but the lawsuits represent something larger — policymakers want more scrutiny and oversight for companies that make and deliver painkillers instead of heaping blame on people who suffer from addiction.

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Disclaimer: The viewpoint expressed in this article is the opinion of the author and is not necessarily the viewpoint of the owners or employees at Healthcare Staffing Innovations, LLC.

South Carolina Sues Oxycontin Maker Purdue over Opioid Marketing

The lawsuit by South Carolina Attorney General Alan Wilson, filed in Richland County Court of Common Pleas in Columbia, accuses the company of the unfair and deceptive marketing of opioid painkillers.

from Reuters

South Carolina sued Purdue Pharma LP on Tuesday, becoming the latest state or local government to accuse the OxyContin maker of deceptive marketing practices that have contributed to a national opioid addiction epidemic.

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Disclaimer: The viewpoint expressed in this article is the opinion of the author and is not necessarily the viewpoint of the owners or employees at Healthcare Staffing Innovations, LLC.

Feds Announce Largest-Ever Crackdown on Opioid-Related Health Care Fraud

The crackdown on opioid-related cases was reported as part of the Justice Department’s annual announcement of health care fraud enforcement efforts.

from STAT

Federal law enforcement agencies announced today what they called “the largest opioid-related fraud takedown in history” with the arrest of 120 people across the country, including doctors allegedly running pill mills and the operators of fraudulent treatment centers.

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Disclaimer: The viewpoint expressed in this article is the opinion of the author and is not necessarily the viewpoint of the owners or employees at Healthcare Staffing Innovations, LLC.

Are Pharmaceutical Companies to Blame for the Opioid Epidemic?

Recent lawsuits are asking courts whether the current crisis is comparable to the one over tobacco in the ’90s.

from The Atlantic

Opioid abuse is rampant in states like Ohio, where paramedics are increasingly spending time responding to overdoses and where coroners’ offices are running out of room to store bodies. In 2012, there were 793 million doses of opioids prescribed in the state, enough to supply every man, woman, and child, with 68 pills each. Roughly 20 percent of the state’s population was prescribed an opioid in 2016. And Ohio leads the nation in overdose deaths.

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Disclaimer: The viewpoint expressed in this article is the opinion of the author and is not necessarily the viewpoint of the owners or employees at Healthcare Staffing Innovations, LLC.

How Pharmacists Can Lead an Opioid Exit Plan

Managing post-op pain is a team effort—and who better to lead the team than a medication expert?

from ModernMedicine

A paper in JAPhA highlights the important role pharmacists can play in leading an opioid exit plan (OEP). The paper, “Opioid exit plan: A pharmacist’s role in managing acute postoperative pain,” is a case study of how the pain management team at St. Joseph Mercy Hospital in Ann Arbor, MI, operates. St. Joseph’s developed a pharmacist-led OEP that has been successful in helping to manage postoperative pain and provide patient education.

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Disclaimer: The viewpoint expressed in this article is the opinion of the author and is not necessarily the viewpoint of the owners or employees at Healthcare Staffing Innovations, LLC.

Nurse Licensing Laws Block Treatment for Opioid Addiction

Laws in more than half the states are likely to prevent NPs from using their licenses in rural areas that need it most.

from The Pew Charitable Trusts

Confronting an opioid overdose epidemic that is killing at least 90 people every day, two federal agencies this month gave more than 700 nurse practitioners and physician assistants the authority to write prescriptions for the anti-addiction medication buprenorphine.

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Disclaimer: The viewpoint expressed in this article is the opinion of the author and is not necessarily the viewpoint of the owners or employees at Healthcare Staffing Innovations, LLC.

The Role of the Nurse in Preventing Opioid Abuse

Nurses can play an important role in reducing opioid deaths through their assessments and monitoring of patients.

from Minority Nurse

Overdose deaths related to prescription opioids have quadrupled since 1999, according to the Centers for Disease Control and Prevention (CDC), which has made it a topic of dinner conversation as well as a top priority in health care. Nurses can play an important role in reducing these deaths, as well as addiction problems, through their assessments and monitoring of patients. But it’s also important for nurses to be well aware of steps they can take to help protect themselves from possible legal action stemming from opioids.

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Disclaimer: The viewpoint expressed in this article is the opinion of the author and is not necessarily the viewpoint of the owners or employees at Healthcare Staffing Innovations, LLC.

The Opioid Epidemic and Untreated Pain: Ethical Tensions

Research shows that since 1999, consumption of hydrocodone has more than doubled and consumption of oxycodone increased by nearly 500%.

from Johns Hopkins Nursing

I recently attended a funeral for one of my former classmates from high school who died of a heroin overdose. Tragically, there was more than one funeral that day. There had been two overdoses within my community in one week. With recent headlines such as, “21 heroin overdoses reported in Ohio in a day,” and “Maryland reports 383 overdose deaths in the first three months of 2016,” I am less surprised by such events, but increasingly alarmed.

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Disclaimer: The viewpoint expressed in this article is the opinion of the author and is not necessarily the viewpoint of the owners or employees at Healthcare Staffing Innovations, LLC.