Safe Opioid Prescribing

Multiple state and national associations are working on this issue and each year brings new resources. The Integrated Healthcare Association (IHA) has made a compendium of resources available here, for various targeted providers and provider organizations.

Another valuable resource is the California Opioid Overdose Surveillance Dashboard, which presents regular updates on opioid prescription and overdose trends. The site is a cooperative venture of CDPH, OSHPD and the California Health Care Foundation.

Please scroll down to find regional and other resources on the issue.

General Information

Prescription opioid drug dependence, misuse, abuse and drug related overdose deaths have become a public health emergency. By 2009, drug overdose deaths outnumbered deaths due to motor vehicle crashes for the first time in the U.S.ⁱ Opioid analgesics were involved in 30 percent of drug overdose deaths where a drug was specified in 1999, compared to nearly 60 percent in 2010.ⁱⁱ Opioid-related overdose deaths now outnumber overdose deaths involving all illicit drugs such as heroin and cocaine combined.ⁱⁱⁱ

The increased morbidity and mortality related to prescription opioid drug usage have led to an exponential increase in emergency department visits. The total number of drug-related ED visits increased 81 percent from 2004 (2.5 million) to 2009 (4.6 million).^iv Despite emergency departments prescribing only a fraction of those prescriptions written nationally, ED prescriptions for opioids are reported to account for approximately 45 percent of those opioids diverted for non-medical use.^v With pain being one of the most common chief complaints among emergency department patients, the ED is at the forefront of treating and curtailing the propagation of this national epidemic.

The Path to Progress – A Personal View

Dr. Kelly Pfeifer (above) recently retired from a leadership role with California Health Care Foundation. She had this to say about progress on the opioid front in the state.

“In the last four years, overall opioid prescribing in California is down 34 percent, and buprenorphine prescribing in Medi-Cal has quadrupled. While we have much work to do in this state, California is faring better than the US as a whole… California has been rapidly building new capacity to treat opioid addiction and substance use disorders more broadly.

“Many of the programs CHCF helped to pilot are now being scaled through the California MAT Expansion Project at the Department of Health Care Services (DHCS), which is building new MAT capacity in over 50 emergency departments and hospitals, 65 primary care clinics, 10 mental health clinics, maternity care practices, 29 county jail systems, and countless residential treatment programs…

“Dozens of counties have also been hard at work rolling out the Drug Medi-Cal Organized Delivery System to ensure that all Medi-Cal enrollees have access to the full range of substance use disorder treatment services. CHCF is proud to support these efforts.”

Safe Prescribing Links

Links for Los Angeles County and Orange County safe prescribing resources are also available. 

Access Los Angeles Prescription Drug Abuse Medical Task Force resources here.

Visit the Orange County Collaborative on Prescription Drug Abuse here.

Learn more about the role prescribers can play in checking the nation’s opioid crisis by viewing the video “Do No Harm.”

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