Long-term opioid therapy can cause harm ranging in severity from constipation and nausea to opioid use disorder and overdose death. Certain factors can increase these risks, and it is important to assess and follow-up regularly to reduce potential harms. Long term care facility healthcare professionals including nurses, physicians and administration should educate patients and families regarding the harms of opioid therapy. All healthcare professionals have an obligation to assess factors that can increase patient’s risk for harm. Ask your patient about concerns and determine any harms they may be experiencing such as: nausea or constipation, feeling sedated, breathing interruptions during sleep and craving more opioids than prescribed or difficulty controlling use. Patients that have become addicted to opioids require the drugs to avoid painful withdrawal. Withdrawal symptoms from opioids may include drug craving, anxiety, insomnia, abdominal pain, vomiting, diarrhea, and tremors. Tapering plans should be individualized but in general the following apply: Go Slow, Consult with specialists and provide support. Prescribers must educate those patients that have higher dosage and higher risk. Prior to prescribing opioids, prescribers are required to consult with the E-Force clearing house and review the patients history of opioid use. High Morphine milligram equivalent (MME) per day scores that exceed 50 MME/day identify patients who would benefit from closer monitoring, reduction or tapering of opioids, prescribing
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Everything you think you know about addiction is wrong
Controlled Substances Bill Passed by Florida Legislature in 2018, the Controlled Substances Bill establishes prescribing limits, requires continuing education on controlled substance prescribing and expands required use of Florida’s Prescription Drug Monitoring Program, EFORCSE. New Requirements are effective July 1, 2018 PUBLIC SERVICE VIDEO Board of Pharmacy Chair, Jeenu Philip, provides Pharmacists with an overview of Florida’s Controlled Substance Bill that went into effect on July 1, 2018. The implementation for these requirements are changing daily, until all mandates and concerns are addressed. For updates and more information regarding the legislation, please visit flhealthsource.gov/FloridaTakeControl. Prescription limits for Acute Pain Prescribing practitioner may prescribe up to a 3-day supply of a Schedule II opioid for acute pain Up to 7-day supply if physician determines: More than 3-day supply is needed based on professional judgment Written indication “acute pain exception” on the prescription, AND Justification for deviating from 3-day limit is documented in patient’s medical record As defined on Florida Take Control website, “Acute pain” is the normal, predicted, physiological, and time-limited response to an adverse chemical, thermal, or mechanical stimulus associated with surgery, trauma, or acute illness. It does not include pain related to cancer, terminal conditions, pain treated with palliative care, or traumatic injuries with an Injury Severity Score of 9 or greater Prescriptions for non-acute pain If prescriber writes
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