There are significant risks associated with the long-term use of opioids, yet many patients depend on them for long-term pain management. A growing body of research shows that the right treatment approach can make patients safer, even when using opioids in the long term.
Risks of Long-Term Opioid Use
Chronic pain affects millions of Americans, creating an estimated $600 billion each year in medical costs and lost productivity.
While long-term opioid use can help reduce pain and maintain quality of life, there are numerous risks. Besides increased tolerance, dependence, and addiction, other potential issues associated with long-term opioid use include:
Nausea and bowel disorders
Depression and anxiety
Sleep disturbances and abnormal breathing
Increased risk of falls
If a patient’s pain is best managed with long-term opioids, they likely have complex healthcare needs. This makes opioid use a complicated decision. Providers have to consider many factors, including the patient’s quality of life, when deciding whether to recommend continuing or tapering off opioid use.
What New Research Shows
In a study described in Mayo Clinic Proceedings, researchers evaluated how the use of healthcare changed among 772 patients. Study participants\ were receiving long-term opioid therapy for chronic, non-cancer pain. These patients were enrolled in a controlled substance agreement (CSA) in 2015.
Researchers looked at patient data 12 months before and after CSA enrollment. Specifically, they looked for a decrease of 1 or more hospitalizations or emergency department visits and 3 or more outpatient primary and specialty care visits.
Study results indicated that CSA enrollment was associated with decreased outpatient primary care visits. Among patients with greater comorbidity, CSA enrollment was associated with fewer outpatient primary care visits and reduced specialty care visits.
Qualities of an Effective Controlled Substance Agreement (CSA)
Patients in the CSA received an individualized plan for managing their pain. This included:
Prescription monitoring programs
Drug testing to evaluate the patient’s opioid use
Advising CSA participants to have only one care team prescribe the opioids
Expectations for follow-up appointments among patients
Showing patients how to store medications safely
Warning patients not to share medications
Warning patients not to change doses without contacting the prescriber
Medication-Assisted Treatment for Opioid Dependency
For patients with opioid use disorders (OUD), there are numerous options for reducing dependence.
Medication-assisted treatment (MAT) has been shown to be an effective form of treatment. This approach uses one of three FDA-approved medications, along with counseling and behavioral therapies. The three medications currently approved for treating opioid dependence include buprenorphine, methadone, and naltrexone.
Because of the effectiveness of MAT, the FDA recommends that anyone seeking treatment for an OUD be offered access to any of the three medications. Because OUD may be a chronic condition, providers and patients should occasionally reevaluate the need for continuing with MAT. It is possible for MAT to be indefinite for some individuals.
Besides understanding of their patients’ treatment needs, behavioral health providers need the right tools to operate an effective practice. Contact BestNotes today to get started with EHR and CRM solutions tailored to your specific needs.