Opioids

Oregon has made national headlines as having the second highest rate of opioid drug abuse in the nation; an alarming story to many who are involved in health care across the state. This statistic has been a call to action and OMA joined the growing statewide efforts to address this issue.

2020 Overdose Toolkit

In October of 2020, the OMA, along with its partner organizations the American Medical Association and the Provider Clinical Support System, is excited to unveil a powerful tool for Oregon clinicians: "Reversing the Overdose Epidemic in Oregon: A Toolkit for Oregon’s Physicians, PAs, and Other Prescribers." The toolkit contains current data; critical state and national guidance for safer prescribing; information on Oregon’s prescription drug monitoring program (PDMP); resources for harm reduction and overdose prevention; and resources for substance use disorder treatment and recovery.

2018 Oregon Opioids Progress

Findings from a May 2018 AMA report demonstrate that efforts by the Oregon Medical Association (OMA) and partner organizations are having the encouraging effects of tackling the opioid crisis in Oregon—but that continuing the positive trend will require sustained and vigorous action on the part of the state’s lawmakers and healthcare providers, as well as the general public.

OMA Opioid Efforts

Leading

Formation of OMA's Opioids Task Force in 2015
Task Force Charter: The Task Force is charged with developing OMA's statewide platform for issues surrounding the prescribing and management of opioids including policy creations, legislative review, member and community education and resources, issue expertise and other issues as they arise around opioid misuse and abuse, as well as appropriate pain management.

OMA Policy Statement

Prescribing Opioids

The OMA adopts the following overarching policy regarding prescription opioids, including, but not limited to, the following:

The OMA recognizes the vital role that physicians and physician assistants (PAs) play in the provision of appropriate pain management services including prescribing opioid analgesics for assessed pain.

The OMA supports the shared decision making process between the prescriber and the patient that includes weighing the risks and benefits of starting or continuing opioid therapy.

The OMA supports the education of physicians and physician assistants regarding the proper assessment, referral and treatment of chronic pain as well as strategies to lessen the diversion, misuse, abuse, and unintentional overdose, and death from opioid pain relievers.

The OMA supports continued clinician input into pain management regulations and legislation.

The OMA encourages physicians and physician assistants to use all available risk assessment tools to improve safety in pain management as is fitting to their practice. The OMA endorses:

Continued research and adoption of evidence-based guidelines for the safe treatment of chronic pain
Increased access to non-opioid modalities that are appropriate for pain care and covered by insurance
The regular use of the Prescription Drug Monitoring Program (PDMP)
Efforts to make the Prescription Drug Monitoring Program (PDMP) more easily accessible to precribers
Regular adherence monitoring and evaluation of a patient's opioid therapy
Increased access to comprehensive addiction evaluation and/or treatment for individuals diagnosed with opioid use disorder

Finally, the OMA endorses public and community education for greater awareness of the risks of opioid prescriptions and options for pain management.

The OMA will work in collaboration with other organizations including other medical associations to address the issue of opioid safety in a holistic manner that ensures patient safety and wellbeing remain at the forefront of prescribing practices. (June 2016)

Legislative Action

2018 HB 4143 - PASSED

Requires the Oregon Department of Consumer and Business Services (DCBS) to study the barriers to medication-assisted treatment for substance use disorder, including access to treatment in rural and underserved areas, and report back to the Legislature with findings
Includes the establishment of an Oregon Health Authority (OHA) pilot project to assess the effectiveness of peer recovery support mentors within Emergency Departments
Requires providers licensed to prescribe opioids to register with the Oregon Prescription Drug Monitoring Program (PDMP) by July 1, 2018

2017 HB 3440 - PASSED

Create and maintain a database for addiction treatment providers and current county overdose statistics
Eases prior authorization rules on withdrawal medication
Allows pharmacists to dispense naloxone without requiring the patient to complete formal individualized training
Enhances the PDMP by streamlining provider enrollment, creating opportunities to identify and review risky prescribing practices, and ensuring appropriate education of prescribers on the state’s recently adopted prescribing guidelines.

2017 HB 2114 - PASSED

Requires the Oregon Medical Board to endorse Oregon’s Opioid Prescription Guidelines and inform licensees of safe prescribing practices

2016 OMA's HB 4124 - PASSED (OMA legislative session win) - OMA introduced HB 4124 to develop policy that:

Develops policy to integrate the PDMP into existing technology to streamline the use of the PDMP
Allows for pharmacists to prescribe and distribute naloxone, without a prescription

2015 SB 839 - PASSED
- "Good Samaritan law" - provides legal immunity to individuals who report an overdose/experience an overdose. Cannot be prosecuted for possession, frequenting location known to sell drugs or possession of paraphernalia with intent to sell/deliver
2013 SB 470 - PASSED

Granted delegate access to the PDMP (designated staff of licensed health care professional can individually log in and pull prescription data)
Requires specific data to be collected and entered on each logged prescription (including number of days prescribed, refills, where dispensed, etc.)
Allows for disclosure of prescriptions by DEA number

Policy

Monitored and submitted comments to the CDC on the initially proposed guidelines for prescribing opioid for chronic pain
Board of Trustees approved adoption of new opioids prescribing guidelines from the Oregon Opioids Prescribing Guidelines Task Force
Action by OMA Board of Trustees

Approved overarching policy on opioids
Approved adoption of opioids prescribing guidelines from the Oregon Opioids Prescribing Guidelines Task Force
Approved adoption of Oregon Pregnancy and Opioids Workgroup Recommendations

Participated in rules advisory committee for HB 4124
Monitored and commented on Health Evidence Review Commission coverage guidelines, including updated guidance on opioids for conditions of the back and spine
Advocated for streamlined PDMP application and achieved removal of notarization requirement
Advocated against tying physician performance to Consumer Assessment of Healthcare Providers and Systems (CAHPS) satisfaction measures; negative scores can influence opioid prescription
Assist members on regulatory questions such as pain management contracts and enforcement, medication-assisted treatment resources, false prescription fraud, and intersection of marijuana and opioids

Communications

Periodic articles on local and national opioid-related efforts
Social Media around opioids, addiction, and mental health
Development of a dedicated Opioids Epidemic webpage on the OMA website
Periodic articles on local opioid-related efforts
Medicine in Oregon, Winter 2016 - Opioid Abuse: Oregon Tackles Escalating Public Health Epidemic
Medicine in Oregon, Winter 2013 - Confronting a Crisis: Opioid Abuse in Oregon

Education

2018 - OMA Annual Conference 2018 with Keynote Sam Quinones speaking about the opioid Epidemic and a breakout session dedicated to prescribing guidelines for acute pain
2018 - Working with AMA on a pilot program to reduce harm from inappropriate use of opioid analgesics
2018 - Developing Opioids Modules and a series of CME webinars
OMA Annual Conference 2016, dedicated to the crisis
Fall Convocation on opioids in 2013
Free Enduring CME: ER/LA Opioid REMS: Achieving Safe Use While Improving Patient Care
Joint Providership, including OMA Accreditation, for programs presented by the Oregon Coalition for the Responsible Use of Medicine and Oregon Pain Guidance