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Statement of Need

Since 1999 opioid prescriptions in the United States have quadrupled, and the number of people who have died from opioid overdose has mirrored this increase. From 2014-2015 Illinois was one of nineteen states that had a statistically significant increase in opioid overdose deaths. In fact, during that time opioid overdoses killed 45% more people than homicides. In addition to risk of overdose, misuse and opioid use disorder are also dangerous, and according to the CDC, every day over 1000 people are treated in the Emergency Room for misuse of prescription opioids. In 2015 the CDC released guidelines on opioid prescribing based on the best available data, and since 2012 voluntary education has been offered to physicians in an effort to mitigate risks, although the targeted number of prescribers has yet to be trained.

The Illinois Department of Public Health and The Illinois Office of the Attorney General recognize the importance of prescriber education in patient care and safety. To address the opioid crisis in Illinois we have partnered to offer an educational toolkit for new prescribers to the state. This module consists of a 15-minute video with best practices in opioid prescribing and an introduction to the Illinois prescription drug monitoring program.

References

  1. Rudd RA, Seth P, David F, Scholl L. Increases in Drug and Opioid-Involved Overdose Deaths- United States, 2010-2015. MMWR Morb Mortal Wkly Rep. ePub: 16 December 2016.
  2. Muhuri PK, Gfroerer JC, Davies C. Associations of nonmedical pain reliever use and initiation of heroin use in the United States. CBHSQ Data Review, 2013.
  3. Shah A, Hayes CJ, Martin BC. Characteristics of Initial Prescription Episodes and Likelihood of Long-Term Opioid Use- United States, 2006-2015. MMWR Morb Mortal Wkly Rep. 2017 Mar 17;66(10):265-269.
  4. Sun EC, Darnall BD, Baker LC, Mackey S. Incidence of and Risk Factors for Chronic Opioid Use Among Opioid-Naïve Patients in the Postoperative Period. JAMA Intern Med. 2016 Sep 1;176(9):1286-93.
  5. Volkow ND, McLellan AT. Opioid Abuse in Chronic Pain — Misconceptions and Mitigation Strategies. N Engl J Med 2016; 374:1253-1263
  6. CDC guideline for prescribing opioids for chronic pain — United States, 2016. MMWR Recomm Rep 2016;65(RR-1):1-49
  7. Frieden TR, Houry D. Reducing the Risks of Relief — The CDC Opioid-Prescribing Guideline. N Engl J Med 2016; 374:1501-1504
  8. Moore T, Jones T, Browder J, Daffron S, Passik S. A Comparison of Common Screening Methods for Predicting Aberrant Drug-Related Behavior among Patients Receiving Opioids for Chronic Pain Management. Pain Med 2009; 10 (8): 1426-1433.
  9. Webster L, Webster R. Predicting Aberrant Behaviors in Opioid-Treated Patients: Preliminary Validation of the Opioid Risk Tool. Pain Med 2005; 6 (6): 432-442.
  10. Meltzer EC, Rybin D, Meshesha LZ, et al. Aberrant drug-related behaviors: Unsystematic documentation does not identify prescription drug use disorder. Pain medicine (Malden, Mass). 2012;13(11):1436-1443.
  11. Reisfield G, Salazar E, Bertholf R. Rational Use and Interpretation of Urine Drug Testing in Chronic Opioid Therapy. Annals of Clinical and Laboratory Science 2007;37(4): 301-314.
  12. Krebs EE, Lorenz KA, Bair MJ, et al. Development and Initial Validation of the PEG, a Three-item Scale Assessing Pain Intensity and Interference. Journal of General Internal Medicine. 2009;24(6):733-738.
  13. US Department of Health and Human Services. Surgeon General’s Call To End The Opioid Crisis website. http://turnthetiderx.org/. Accessed March 2017.

Target Audience

Health care prescribers of all specialties including physicians, dentists, nurse practitioners, and physician assistants.

Learning Objectives

At the conclusion of this activity, participants will be able to:

  • Screen for opioid misuse and use disorder
  • Monitor patients taking opioid medication
  • Use the Illinois Prescription Drug Monitoring Program

Faculty

Audrey Tanksley, MD is an Assistant Professor of Medicine. Dr. Tanksley is a Board-Certified Internist who teaches residents and medical students about addiction. Her research interests focus on evaluating educational innovations that aim to improve patient safety and health equity of care impacting vulnerable populations.

Monique Anawis, MD, JD is the Medical Director for the Office of Illinois Attorney General Lisa Madigan and also serves as Assistant Attorney General. Dr. Anawis is a Board-Certified practicing ophthalmologist who teaches residents and medical students, is a Clinical Professor of Ophthalmology for the Northwestern University Feinberg School of Medicine, and the Technical Expert for the Illinois Prescription Monitoring Program.

The faculty has no conflicts of interest to disclose.

Credit Statement

To receive a certificate of completion for the module, the participant must complete the activity evaluation and correctly answer 6 out of 6 questions (100% pass rate) on the post-test. The test can be accessed by clicking on the appropriate link at the top of this page. Upon successful completion, the participant may save or print their certificate (PDF).

Fee

This activity is complimentary.

Contact

If you have any questions regarding this activity, please contact dph.director@illinois.gov

Grant Funding

This series is made possible with generous funding from the Illinois Department of Public Health.

Disclosures

The staff of the University of Chicago Medical Center has no financial relationships to disclose.

Disclaimer

The information presented in this activity is for medical education purposes only.

The opinions expressed in this educational activity are those of the faculty and do not necessarily represent the views of the University of Chicago Pritzker School of Medicine, the University of Chicago Medicine, or the Department of Hospital Medicine.