Dr Dean Hashimoto’s talk on medical treatment guidelines covered what’s out there, what makes for good guidelines (my words not his) and what happened when MA implemented guidelines for chronic pain.
We’ll focus on Massachusetts’ experience. (here’s a good synopsis of guidelines) The state adopted those guidelines in part because there were an estimated 20 workers’ comp claimants were dying as a results of opioid poisoning (overdose).
Dr Hashimoto identified two impacts of Mass’ adoption of guidelines for chronic pain – these guidelines required use of the state prescription drug monitoring program, random drug screening, a written opioid agreement, and cautions when dosage exceeds 120 morphine equivalents per day.
While it is a bit early to assess results, here’s a couple preliminary findings:
- “there was a leveling off of opioid prescriptions an deaths related to opioid poisoning.”
- A WCRI study reported longer term use of opioids decreased from 11 percent of claimants to 7 percent after the guidelines were implemented.
