Opioid Use Disorders

Providers are in the best position to identify and manage potential opioid overutilization. The CMS finalized new opioid policies for Medicare drug plans starting on January 1, 2019. The new policies include improved safety alerts when opioid prescriptions are dispensed at the pharmacy and drug management programs for patients determined to be at-risk for misuse or abuse of opioids or other frequently abused drugs.

Initial Preventative Physical Exam (IPPE)

During the IPPE, review the patient's medical and social history. Medicare would like to emphasize that review of opioid use is a routine component of this element, including Opioid Use Disorders (OUDs). If a patient is using opioids, assess the benefit from other, non-opioid pain therapies instead, even if the patient does not have OUD but is possibly at risk.):

  • Review potential risk factors for depression and other mood disorders
  • Review functional ability and level of safety
  • Measurement of height, weight, body mass index (BMI), and visual acuity screening
  • End-of-life planning (upon agreement of the individual)
  • Education, counseling and referral based on the review of previous 5 components
  • Education, counseling and referral for other preventive services, including a brief written plan such as a checklist

Annual Wellness Visit

During initial or subsequent AWVs, update medical and family history. Medicare would like to include opioid use in the ‘Review of Medical and Family History' element of the AWV. Providers are encouraged to pay close attention to opioid use during this element of the AWV. If a patient is using opioids, assess the benefit from other, non-opioid pain therapies instead, even if the patient does not have OUD but is possibly at risk.

Centers for Disease Control (CDC)

The CDC has resources to help providers apply the "Guideline for Prescribing Opioids for Chronic Pain."

Access the below documents from the "No Shortcuts to Safer Opioids Prescribing: CDC Commentary" section of the CMS MLN Connects - May 23, 2019.

  • Pocket Guide: Tapering Opioids for Chronic Pain
    • Quick-reference tool for when and how to taper and important considerations for safe and effective care
  • CDC Opioid Prescribing Guideline Mobile App
    • Apply recommendations in clinical practice, including a morphine milligram equivalent calculator, key recommendations, motivational interviewing techniques, resources, and glossary
  • Applying CDC's Guideline for Prescribing Opioids Series
    • Interactive, web-based training featuring 11 self-paced learning modules with case-based content, knowledge checks, and integrated resources

Resources

 

Last Updated Mon, 11 Jan 2021 18:28:35 +0000