Pubdate: Sun, 22 Nov 2015 Source: San Diego Union Tribune (CA) Copyright: 2015 Union-Tribune Publishing Co. Contact: http://www.utsandiego.com/ Details: http://www.mapinc.org/media/386 Note: Seldom prints LTEs from outside it's circulation area. REPORT: STRICTER OPIOID GUIDELINES NEEDED Stricter guidelines for prescribing and dispensing powerful pain medications are needed to curb the nation's deadly opioid epidemic, according to a report released last week from public-health leaders at Johns Hopkins University. The analysis offers broad recommendations for addressing opioid abuse but focuses on the supply chain, including physicians and pharmacists. The report calls for greater monitoring, training and rule-making to prevent misuse of opioids, addiction and overdoses, and said doctors often prescribe pain medications "in quantities and for conditions that are excessive, and in many cases, beyond the evidence base." It calls on states and the federal government to overhaul their rules for prescribing opioids, saying existing guidelines are "too permissive." The Johns Hopkins team applauded Washington state for passing a law that established new dosing criteria and guidance on when to recommend consultation for patients who may be addicted. The report also said medical licensing boards should have greater authority to investigate high-risk prescribers and dispensers. Other recommendations include: mandatory use of patient surveys to track pain, mood and body functionality; urine drug screening; and collection of prescription data to identify patients who may need substance-abuse treatment. Additionally, the report calls for mandatory training in pain management and opioid prescribing for doctors and medical students, including residencies in pain medicine for medical-school graduates. Andrea Gielen, director of the Johns Hopkins Center for Injury Research and Policy, said in a statement that the recommendations "cover the entire supply chain, from training doctors to working with pharmacies and the pharmaceuticals themselves, as well as reducing demand by mobilizing communities and treating people addicted to opioids." The report comes as a Maryland task force appointed by Gov. Larry Hogan is developing recommendations to address opioid abuse. Hogan, who lost a cousin to heroin addiction, has allocated money to treat addicts in county jails and has proposed measures that include increasing capacity at treatment clinics, boosting recovery housing and detoxification services, and disrupting gangs that distribute heroin. Opioid abuse has risen dramatically in recent years, in large part because of addiction to prescription pain pills and a growing use of heroin as a relatively cheap alternative that offers a similar high. Federal survey data from 2010 and 2011 found that 4 percent of Marylanders had used prescription pain relievers for nonmedical purposes within the previous year. The nationwide rate of heroin deaths has nearly quadrupled since 2000, according to the Centers for Disease Control and Prevention. In Maryland, 578 people died of heroin overdoses last year, representing a 25 percent increase over 2013 and more than twice the number in 2010. The Washington Post - --- MAP posted-by: Jay Bergstrom