The Corbett administration and the Pennsylvania Medical Society (PAMED) have been hard at work with several initiatives aimed at tackling the state’s prescription drug abuse crisis. One element of the state’s response to this crisis will be the likely adoption of prescribing guidelines for the treatment of chronic pain.
Currently there are two efforts under way:
The Corbett Administration & PAMED
Background: Late last year, Gov. Tom Corbett established the Safe and Effective Opioid Prescribing Practice and Pain Management Task Force to consider opioid prescribing guidelines. Dozens of stakeholder organizations, including PAMED, have participated in the group’s deliberations.
April 15 — The task force, meeting at PAMED, voted to tentatively approve voluntary guidelines that combine elements of model guidelines drafted by the American Pain Society and the Federation of State Medical Boards. Elements of Ohio’s recently approved guidelines also were included.
April 21 — PAMED’s Specialty Leadership Cabinet (SLC) task force reviewed the latest draft of the Corbett task force’s proposal. Overall, PAMED’s SLC task force was pleased with the document, which closely resembles guidelines now in place in Ohio, but recommends a 100 mg. threshold based on new medical research that came out after Ohio’s guidelines went into effect.
May 20 — The PAMED Board acted on proposed Corbett task force guidelines. Watch for a major announcement.
The guidelines are intended to be voluntary, and would not replace a physician’s independent clinical judgment. They are also intended to be concise, easy to understand, and easy to follow, with links to information that providers can use to dig more deeply into a particular aspect if needed.
The final guidelines will likely encourage physicians to screen patients for histories of alcoholism, mental illness, substance abuse problems, and various other dependencies that could put them at higher risk for opioid dependence or abuse.
The House of Representatives
On April 1, the House passed House Resolution 659, introduced by Rep. Doyle Heffley (R-Carbon County), which directs the Joint State Government Commission, a non-partisan research body, to create a task force to explore the commonwealth’s existing laws and regulations and make recommendations for appropriate changes. The resolution also calls for an advisory committee of subject experts, on which PAMED will have two representatives.
Significantly, before the resolution was passed it was amended to add a provision requiring the Commission’s task force to recommend prescribing guidelines within 60 days of the formation of the advisory committee.
While some have expressed concerns this could result in two different sets of competing guidelines, the groups are in close communication. Rep. Heffley and a representative from the Commission were in attendance at the April 15 Corbett administration task force meeting. Many of the 29 individuals that will be advising the Commission’s task force have also been involved in the governor’s task force.
PAMED has been working to address opioid abuse for years, with our Pills for Ills, Not Thrills campaign, and our advocacy for the establishment of a statewide controlled substance database and unused medication drop-off programs.
As the work of the task forces moves forward, the controlled substances database legislation is also still under consideration. After the House passed House Bill 1694, the Senate responded by acting on Senate Bill 1180. There is an expectation that the differences between the two chambers will be resolved by the end of the June legislative session.
- An Opioid Prescription Guidelines checklist, a new tool that will help physicians discuss pain management with their patients and remind them how to be sure they comply. The checklist is printed in the form of a prescription notepad
- A series of six, one-hour, CME webinars to help educate physicians and other health care providers on the appropriate use of long-acting and extended-release opioids.