Recap: “How to Fight the Opioid Epidemic”

For this year’s spring CME seminars, attorney Brett B. Rowe presented “How to Fight the Opioid Epidemic” in Austin and Houston. Here’s a brief recap with five risk management takeaways for physicians.

1. Avoid treating complex patients suffering from chronic pain if it’s not your specialty.
   • Consider referring these patients to a pain management specialist.
   • Discontinue treating a patient for pain if you have sent him or her to a pain specialist.
2. Supervise your staff and keep them informed about patients who are at risk for opioid abuse. Physician extenders and staff need to know the importance of documenting all interactions related to prescriptions and patient refills.
   • Always inform staff of patients:
     • at risk of prescription abuse.
     • suspected of prescription abuse; or
     • terminated for prescription abuse;
3. Best practice is to follow the CDC Guidelines for Prescribing Opioids.
   • CDC guidelines do not apply to patients receiving cancer treatment, palliative care, or end-of-life care.
   • The more documentation the better. Most physicians aren’t documenting thoroughly enough for chronic pain patients.
4. Query the Prescription Monitoring Program (PMP) database to check if the patient is receiving opioid prescriptions from another physician.
   • Beginning September 1, 2019, all prescribers must query the patient’s prescription history in the PMP before issuing opioids, benzodiazepines, barbiturates, and carisoprodol. (TX HB2561)
   • Document every time you query the PMP.
   • To register for the PMP, visit: https://texas.pmpaware.net/identities/new
5. Texas Medical Board (TMB) Bulletins do not list physicians being disciplined for NOT prescribing opioids.
   • A review of TMB Bulletins in 2016-2018 did not show disciplinary actions against physicians for withholding prescription opioids to patients.
   • However, numerous disciplinary actions were given to physicians who overprescribed, non-therapeutically prescribed, failed to identify high-risk patients before prescribing, or failed to identify drug-seeking behavior.

A recording of this seminar will be available on our CME site at a later time. The course is worth 2 CME credits, including 1 ethics credit. Completion of the course may earn policyholders a 3% discount on their next eligible policy renewal.