Assistant Clinical Professor of Medicine UCLA David Geffen School of Medicine Los Angeles, California
In 2013, the Veterans Health Administration (VHA) implemented the most comprehensive assessment and overhaul of opioid prescribing and pain care of any healthcare system in the country. This sweeping reform was labeled the Opioid Safety Initiative (OSI) and attempted to curb inappropriate opioid prescribing and provide alternative pain care strategies. This course will discuss the initiative in detail, including the many difficulties encountered and valuable lessons learned. Further, the presenters will provide a deep dive into how VHA successfully decreased inappropriate prescribing, expanded access to nonpharmacological modalities, and improved safety for those maintained on opioids. In addition, the VA/DoD Clinical Practice Guideline of Opioid Therapy for Chronic Pain (2017) will be reviewed along with key differences from the CDC Guideline as related to Veteran’s care. Now more than ever, providers are faced with the difficult task of reducing opioid prescribing and simultaneously improving function, all while minimizing risk. The lessons from VHA will enable healthcare providers to successfully reduce a reliance on opioids and minimize risks related to opioids and tapering, while exploring aspects of multimodal pain care.
Describe factors that increase risk for adverse event for those on long-term opioid therapy (LTOT)
Cite the appropriate precautions for patients on opioid maintenance therapy
Summarize the steps taken by VA to improve patient safety
List the key tenants of VA/DoD guidelines for safe opioid prescribing