Turning the tide on Pennsylvania’s opioid crisis will take a team effort. That includes constant communication and collaboration from various members of the health care team – from physicians to nurse practitioners to pharmacists.
Patients also have to be willing to do their part.
One way for medical prescribers to hold their patients accountable is through narcotic contracts, said numerous prescribers who participated in the online educational series “Addressing Pennsylvania’s Opioid Crisis: What Health Care Teams Need to Know.”
“This allows the patient to be equally as responsible,” said Cynthia Ferrari, PA-C, a physician assistant from outside Philadelphia. “I think as doctors, PAs, nurse practitioners, we’re trying to make it better so patients have a better quality life and can take care of themselves and live independently. But we know now, especially looking at studies, that there’s a limit to where we find (opioids) beneficial and beyond that it’s not really benefiting the patient. If anything, we’re harming the patient.”
Unfortunately, most patients do not realize the risks and limitations. They need educated, and that’s another goal for any narcotic contract.
“It’s very important that you set limits with people and that you not make it easy for them to become addicted,” said John Goldman, MD, vice president of inpatient medicine at Pinnacle Health in Harrisburg. “You need to make sure you’re the only one giving them meds, so you know how much they’re being given.”
What should be included in patient contracts? Dr. Goldman recommends adding the following items:
- Patients should only receive opioid medications from their primary care prescriber. That means they are forbidden to seek refills from the emergency department or an urgent care center.
- Patients agree to a regular but random urine drug screening. This ensures they take the proper doses of their medication, are not diverting or selling them, and aren’t taking other illegal substances.
- Patients need to see their primary care provider on a regular basis in order get refills. They should not simply call to order refills.
Tools For Prescribers
- The Pennsylvania Medical Society’s Opioid Prescription Guidelines checklist is a tool designed to help physicians and other prescribers discuss pain management with their patients and educate them how to comply.
- The Pennsylvania Medical Society, in collaboration with the Pennsylvania Department of Health and other health care associations, is creating a multi-part online educational series for prescribers. Part 1 of “Addressing Pennsylvania’s Opioid Crisis: What Health Care Teams Need to Know” teaches prescribers how to effectively use the new voluntary state opioid prescribing guidelines, and is now available at www.pamedsoc.org/opioidresources.