< Back to Press Room

http://www.ama-assn.org/amednews/2010/10/25/prsb1025.htm

Opioid safety is focus of $1 million-a-year educational initiative

October 25, 2010

 

Opioid safety is focus of $1 million-a-year educational initiative

Industry-supported PainSAFE targets how physicians and patients can avoid abuses and misuses of pain treatments.

A group that represents patients living with pain has launched an initiative aimed at educating physicians and patients on how to prescribe and use opioids and other pain treatments safely.

The $1 million-a-year project is called Pain Safety & Access for Everyone, or PainSAFE. It comes in response to a striking rise in deaths and overdoses related to opioid abuse and controversy over how the drugs are marketed.

The effort is supported by contributions from Endo Pharmaceuticals Holdings, King Pharmaceuticals and Medtronic, makers of pain medications and implantable therapies.Fatal opioid overdoses tripled to nearly 14,000 deaths from 1999 to 2006, according to Centers for Disease Control and Prevention data reported in September 2009. In June, the CDC estimated that 305,885 emergency department visits in 2008 were related to opioids, more than double the 2004 estimate of 144,644.

The firms exert no control over PainSAFE educational content, said Will Rowe, executive director of the American Pain Foundation, the Baltimore-based, physician-founded group behind the project. The foundation has long-standing ethics policy designed to prevent industry support from influencing content, he added.

Fatal opioid overdoses tripled to nearly 14,000 deaths from 1999 to 2006.

The PainSAFE website features separate educational tracks for patients as well as physicians and other prescribers, with webinars, posters and frequently-asked-questions pages. The group plans to offer physicians continuing medical education credits for its content. Educational modules now focus on opioid therapy and implantable pain therapies. Content to come next year will address the safety of complementary and alternative therapies and over-the-counter medications such as acetaminophen.

"We are aware that there are safety concerns about the abuse of pain medications, and those concerns tend to lead to less use of available treatments," Rowe said. "Our notion is that if people have a better idea how to use these treatments safely, they will be more inclined to use them, and therefore people will benefit more. If you know how to fly a plane, you're more likely to get in the cockpit and do it."

The initiative comes as the Food and Drug Administration continues to consider a Risk Evaluation and Mitigation Strategy for long-acting and extended-release opioids such as fentanyl and oxycodone.

An FDA advisory panel in July rejected as too lenient an agency proposal to require manufacturers of these medications to boost their efforts to educate physicians and patients about the abuse potential of the drugs through medication guides, patient education sheets and CME. Many panel members said the FDA safety plan also should target immediate-release opioids and argued that physicians should be required to take CME courses to prescribe opioids.

The FDA is analyzing how to proceed, an agency representative said.

Building on guidelines

The two leading professional organizations devoted to pain medicine, the American Academy of Pain Medicine and the American Pain Society, jointly released clinical guidelines last year for physicians using opioids to treat patients with chronic noncancer pain. But that advice falls short in helping physicians prescribe opioids safely, said Lynn Webster, MD, who helped develop the PainSAFE educational materials.

"With those guidelines, they attempted to make their recommendations evidence-based," said Dr. Webster, medical director of Lifetree Clinical Research and Pain Clinic in Salt Lake City. "There's a paucity of evidence out there, but there's a lot of clinical know-how. ... We've come up with some recommendations for physicians to target specifically how to avoid overdose deaths."

PainSAFE is closely modeled on Dr. Webster's Zero Unintentional Deaths educational campaign in Utah. Among the things that can put patients at risk for death when taking opioids: asthma, undiagnosed sleep apnea and rapid titration of methadone.

Scott M. Fishman, MD, a past president of the American Academy of Pain Medicine and now chair and president of the American Pain Foundation's board of directors, said PainSAFE is one of many ways to spread the word to physicians on how to treat pain safely. Neither the academy nor the American Pain Society has officially endorsed PainSAFE.

A principal focus of the project is clarifying the patient's role in avoiding misuse, said Samantha Libby-Cap, director of the initiative.

"The responsibility for the patient is: 'You need to follow this as prescribed,' " she said. "If the pain isn't going away, you need to go back to your health care professional, and they may need to change something. ... But instead of going back to the doctor, they think, 'I'll take another pill, and that will make me feel better.' That's where your unintentional overdoses are coming from."

 

Opioid safety suggestions

Opioid therapy can be effective in treating patients with chronic pain, but it is sometimes associated with fatal abuse, misuse and accidental overdose. A new initiative from the American Pain Foundation aims to educate doctors and patients about how to use these and other pain treatments safely. Here are the foundation's eight tips for physicians prescribing opioids:

Assess patients for risk of abuse before opioid therapy and manage appropriately. Watch for and treat comorbid mental health disorders when they occur. Use conventional conversion tables cautiously when switching from one opioid to another. Avoid combining benzodiazepines with opioids, especially during sleep hours. Start methadone at a very low dose and titrate slowly regardless of whether patients are opioid-tolerant or not. Assess for sleep apnea in patients on high daily doses of methadone and other opioids and in those with a predisposition. Tell patients on long-term opioid therapy to reduce opioid dose during upper respiratory infections and asthmatic episodes. Avoid using long-acting opioid formulations for acute postoperative and trauma-related pain.

Spread the word. Help us education, research and save lives.

Facebook   Twitter
Donate Now

Media Coverage

November 16, 2012
Physicians take lead role in confronting opioid misuse, but still face hurdles: This is the second in a series exploring the intersections between effectively caring for people living with chronic pain and the rise in unintentional poisoning deaths due to prescription painkillers. (The first post is here.) The series will explore the science and policy of balancing the need for treatment as well as the need to prevent abuse and diversion. This week’s story looks at clinical efforts to reduce the risk of opioid abuse and overdose while still caring for patients; the next story will explore the role of public health officials in curbing opioid abuse. Read More

November 14, 2012
AMA webinar spells out 8 ways physicians can curb opioid misuse: The Association holds the first in a series of webinars to teach doctors more about appropriate pain management. Read More

September 17, 2012
FDA Warns of Serious Skin Burns from Topical Pain Relievers: FDA Warns of Serious Skin Burns from Topical Pain Relievers Read More

July 3, 2012
Methadone deaths may have peaked, feds say: CDC » Doctors are more cautious about prescribing methadone for pain because of federal, state warnings. Read More

April 9, 2012
Filling In the Gaps on Pain Prescriptions: Filling In The Gaps On Pain Prescriptions Read More

April 5, 2012
Opioid Rotation Practices Linked to Fatalities: Opioid Rotation Practices Linked to Fatalities Read More

April 3, 2012
Switching Opioids Increases Risk of Overdose Death, Study Says : Switching Opioids Increases Risk of Overdose Death, Study Says Read More

April 2, 2012
Changing Opioids Causing More Overdose Deaths : Changing Opioids Causing More Overdose Deaths Read More

April 1, 2012
Doctors kill thousands due to 'death tables,' Utah expert says in new study : Reference tool responsible in death toll from prescription painkillers Read More

April 1, 2012
Opiate conversion charts killing patients : Opiate conversion charts killing patients Read More

March 8, 2012
What Whitney Houston Teaches Us: Whitney Houston has died from an as-yet unknown cause, but prescription medications are rumored. Her struggles with substance abuse are well documented, because she honestly shared them with the public in hopes of finding her road back. Celebrity deaths bring to our attention the national public health crisis with prescription drugs, and the list is growing: Health Ledger, Anna Nicole Smith, Corey Haim, Mike Starr. These people are not apart from or above us but hold a mirror up to our own lives. Most healthcare practitioners and counselors know a client, a friend or even a family member who has met the same tragic fate. Read More

March 2, 2012
LifeSource Co-Founder Lynn R. Webster, M.D. Receives Inaugural AAPM Presidential Excellence Award for Education: The American Academy of Pain Medicine initiates award to honor Dr. Webster’s work on the AAPM Safe Opioid Prescribing Initiative. Read More

January 12, 2012
The Chronic Pain Problem : Millions of Americans are affected by debilitating chronic pain, and diagnosis and treatment remain a challenge. Read More

November 2, 2011
Study shows Utah a leading state in painkiller deaths : A new study shows that painkiller abuse has not only reached epidemic levels in the United States, but overdose deaths continue a disturbing rise. Read More

November 1, 2011
Prescription Painkiller Overdoses in the US: Overdose deaths from prescription painkillers have skyrocketed during the past decade. Read More

September 14, 2011
Family: Player died from methadone overdose: Family members say a North Carolina high school quarterback died after a big victory last month after accidentally overdosing on some of his grandmother’s pain medication. Read More

August 26, 2011
Dr. Webster Pain Med Safety Interview: Host: Dr. Brian Grieves Radio station # (715) 524-2194 About: Dr. Brian Grieves is a radio show host at WTCH-AM, an affiliation WOTE-AM, both radio stations at Wisconsin. Every Saturday he gives his professional advice on "Health Talk" to his avid listeners in Shawano. Prior to working as a chiropractor, Grieves earned his Bachelors degree from the University of Wisconsin, a doctorate degree from Northwestern College, and his Masters Degree in Public Health from the University of Massachusetts. Read More

June 30, 2011
Dramatic increase of prescription-drug abusers seeking treatment: Dr. Webster joins KCPP to discuss trends in prescription drug abuse. Read More

June 23, 2011
'Rapid detox' a quick fix for opiate addiction?: USA Today Read More

June 15, 2011
LIFESOURCE ANNOUNCES NEW STUDY FINDINGS AVAILABLE ON DEATHS RELATED TO PRESCRIPTION OPIOD THERAPY: Nonprofit organization strives to address one of the nation’s biggest healthcare problems Read More

April 27, 2011
American Pain Foundation Announces New NSAID and Acetaminophen Pain Medication Safety Module and Public Service Announcement for PainSAFE Read More

April 20, 2011
U.S. Aims to Reduce Overdose Deaths, But Will the New Plan Work?: U.S. Aims to Reduce Overdose Deaths, But Will the New Plan Work? By MAIA SZALAVITZ Wednesday, April 20, 2011     The Obama administration announced on Tuesday a new initiative to reduce prescription painkiller Read More

April 19, 2011
Striving Toward Quality Pain Management: The epidemic of untreated chronic or recurrent pain has lasted for decades, yet millions of people are still not adequately treated. One significant barrier to effective pain management is that clinicians and patients are often reluctant to talk about pain... Read More

April 11, 2011
National Prescription Drug Abuse Expert From Utah To Present At Public Town Hall Meeting In Reading: Medical experts and law enforcement provide insights on adolescent prescription drug addiction Read More

March 22, 2011
National Prescription Drug Abuse Experts To Meet With White House Policy Makers: Experts will address prescription pain medication misuse and accidental overdose deaths with the White House Office of National Drug Control Policy Read More

March 10, 2011
National Prescription Drug Abuse and Overdose Deaths Expert Addresses Healthcare Professionals In Houston: Lynn R Webster, M.D. Read More

February 12, 2011
For Some Troops, Powerful Drug Cocktails Have Deadly Results: February 12, 2011 This article was reported by James Dao, Benedict Carey and Dan Frosch and written by Mr. Dao.   In his last months alive, Senior Airman Anthony Mena rarely left home without a backpac Read More

February 5, 2011
There are ways to help, prevent prescription drug abuse:   CHARLESTON, W.Va. -- Recently The Charleston Gazette ran a series on the emerging epidemic of prescription drug abuse. In a state with the highest rate of drug-related deaths, highlighting prescription drug abuse is an important public Read More

January 24, 2011
Morphine/Oxycodone Combination Superior to Separate Components: Montreal Read More

January 20, 2011
I Am An Addict:   Millions of older Americans are making this confession. Families are being torn apart. The good news: There's help Clean and sober for more than five years, Ron Dash has rebuilt his marriage and his life. “When I saw what Read More

January 10, 2011
Patients suffer when doctors are too scared to prescribe pain pills : Patients suffer when doctors are too scared to prescribe pain pills Monday, January 10, 2011; 8:36 PM    Every American should be concerned about the kind of message sent by the Jan. 2 front-page article "Doctors who pre Read More

December 15, 2010
Chronic pain patients, providers get new website:       Kathy Hahn Read More

December 9, 2010
Should an Overdose Antidote Be Made More Accessible?:   I've been writing about naloxone — the antidote to overdose of heroin, oxycodone or similar drugs — for more than 10 years, most recently for TIME here. The dru Read More

November 9, 2010
Addiction to painkillers hobbles more patients : ST. LOUIS — Nichole Marie Case unwittingly became dependent on opioid painkiller drugs. She's not alone. The National Institute on Drug Abuse estimated in 2008 that 1.85 million people in the United Stat Read More

October 25, 2010
Opioid safety is focus of $1 million-a-year educational initiative :   Opioid safety is focus of $1 million-a-year educational initiative Industry-supported PainSAFE targets how physicians and patients can avoid abuses and misuses of pain treatments. A group that represents patients living with pai Read More

February 11, 2010
The Effect of Academic Detailing on Curbing Opioid-Related Deaths in Utah

February 11, 2010
Root Cause Analysis for Unintentional Overdose Deaths Involving Opioids in Chronic Pain Patients Reveals Disproportionate Methadone Involvement

February 11, 2010
Costs of Oral Pain Medications Pre-IT Pump Implantation Compared to Post-IT Pump Implantation: A Retrospective Analysis

February 11, 2010
Select Medical-Legal Reviews of Unintentional Overdose Deaths

February 11, 2010
Comparison Of The Theoretical Cost Of Morphine And Prialt

November 18, 2009
To Help Healing, Doctors Pay More Attention to Pain. Morning Edition. National Public Radio.: The old notion that pain is somehow "good" for you should be put to rest for good, say health officials. They are increasingly recognizing that control of pain leads to more rapid recovery for hospitalized patients, and can even cut costs. Read More

November 28, 2006
National Expert from Utah Spearheads Educational Campaign: FDA Issues Methadone Warning: Providing Safe Access to Pain Medications. SALT LAKE CITY, Utah – November 28, 2006 – The Food and Drug Administration issued a warning yesterday to healthcare profe Read More

October 24, 2006
Prescription Medication Deaths Are On The Rise: Six Steps You Should Know: National Expert Calls for "Zero Unintentional Deaths" with Brigham City Physicians  SALT LAKE CITY, Utah – National pain medicine expert Dr. Lynn R. Webster will present his education campaign entitled Read More

October 18, 2006
Local Pain Medicine Specialist Calls for Zero Unintentional Deaths: National Education Campaign Comes to Brigham City Community Physicians. SALT LAKE CITY, Utah – October 18, 2006 – Dr. Lynn R. Webster, President of the Utah Academy of Pain Medicine and Medical Directo Read More

October 18, 2006
National Expert Calls for Zero Unintentional Deaths: National Expert Calls for "Zero Unintentional Deaths" with Hawaiian Physicians SALT LAKE CITY, Utah – National pain medicine expert Dr. Lynn R. Webster will present his education campaign entitled “Zero Unintentional Overdose D Read More

September 27, 2006
Methadone Related Deaths On The Rise : Six Steps You Should Know SALT LAKE CITY, Utah – Dr. Lynn R. Webster, President of the Utah Academy of Pain Medicine and Medical Director of Lifetree Clinical Research® & Pain Clinic in Salt Lake City, announces six steps to avoid acci Read More

September 20, 2006
Local Pain Medicine Specialist Calls for Zero Unintentional Deaths: Statewide Education Campaign Goes National SALT LAKE CITY, Utah – Dr. Lynn R. Webster, President of the Utah Academy of Pain Medicine and Medical Director of Lifetree Clinical Research® & Pain Clinic in Salt Lake City, announced that h Read More

September 18, 2006
Local Pain Medicine Specialist Calls For Zero Unitentional Deaths: National Education Campaign Comes to St. George Community SALT LAKE CITY, Utah – Dr. Lynn R. Webster, President of the Utah Academy of Pain Medicine and Medical Director of Lifetree Clinical Research® & Pain Clinic in Salt Lake City, a Read More

June 8, 2006
Dr. Lynn R Webster Kicks Off Statewide Education Campaign: LOCAL PAIN MEDICINE SPECIALIST CALLS FOR ZERO UNINTENTIONAL DEATHS SALT LAKE CITY, Utah – Dr. Lynn R. Webster, President of the Utah Academy of Pain Medicine and Medical Director of Lifetree Clinical Research® &a Read More

Go to Press Room