An Orientation to Oregon's New Overdose Toolkit

October 22, 2020—Joy Conklin, the OMA’s Vice President of Practice Advocacy, spoke with Katrina Hedberg, MD, MPH, an affiliate professor in the Oregon Health & Science University-Portland State University School of Public Health and former Health Officer and State Epidemiologist for the Public Health Division of the Oregon Health Authority, about "Reversing the Overdose Epidemic: A Toolkit for Oregon Physicians, Physician Assistants, and other Prescribers."

Can you describe the new toolkit?

Dr. Hedberg: The “Reversing the Overdose Epidemic” toolkit is a seven-page resource guide for physicians and other healthcare providers who want more information on responding to the overdose epidemic. Information is broadly encompassed in five areas: 

1. Current data on overdose deaths (including deaths from prescription opioids as well as drugs of misuse and abuse) and prescribing practices nationally and in Oregon
2. Required pain management training and guidelines on opioid prescribing and tapering
3. Overdose prevention with naloxone and treatment of substance use disorders
4. Public education on the overdose crisis and patient resources
5. OMA partners and policy initiatives to address the overdose crisis

Each of these topic areas lists key sources of information and additional resources, with links to the appropriate organizations and websites. Contributing partner organizations include the American Medical Association, Oregon Medical Association, and Providers Clinical Support System. I myself am honored to take a lead role in promoting the toolkit to Oregon's physicians, physician assistants, and other healthcare workers.

How will the toolkit help physicians, physician assistants, and their practices? 

Dr. Hedberg: The toolkit is intended to be a comprehensive one-stop shop for providers. The material includes both national and Oregon-specific data and resources. The toolkit offers the larger context and strategies for addressing the overdose crisis, as well as specific tools such as applicable state laws, guidelines, and flow charts for clinicians—even links that are helpful to patients. 

Why is the toolkit being launched now?

Dr. Hedberg: When the toolkit project was initially conceived two years ago, it was focused primarily on resources for addressing the prescription opioid overdose epidemic. Since that time, significant progress has been made to decrease opioid prescribing, resulting in fewer opioid overdose deaths.  

Nonetheless, the rate of deaths from prescription opioids in Oregon in 2018 is still nearly double what the rate was in 2000.  Moreover, the rate of overdose deaths from illicit opioids (e.g. fentanyl and heroin) and the rate of deaths from stimulants have increased markedly.  We need the support of all clinicians in Oregon to help reverse these trends. 

What can each individual clinician do to help reverse the overdose epidemic?

Dr. Hedberg: Oregon physicians and other healthcare providers can play crucial roles in responding to the overdose crisis. Every clinician can assume the role of “champion” within their practices. This includes being aware of the current science and evidence base related to managing pain, and the intersection between physical pain and mental/ behavioral health. Clinicians can adopt standards of practice that follow current guidelines and stay up to date on the latest information. 

Those interested in developing and implementing policies to address the epidemic can assume the role of an “advocate."  The toolkit outlines a call to action that includes policy recommendations made by the AMA Pain Care Task Force. These recommendations urge policymakers to remove barriers to evidence-based treatments for patients with chronic pain and those with a substance use disorder. Clinicians can have a key voice in advocating for needed policy changes at the local, state, and national levels.