May CDC Opioids Update

An Opioid Prescribing Interactive Online Training Series for Providers

An interactive online training series that supports providers in practicing safer and more effective opioid prescribing for chronic pain in primary care setting is now available! This series currently includes 11 modules that feature recommendations from the CDC Guideline for Prescribing Opioids for Chronic Pain. Providers can move through each module at their own pace while learning about important factors to consider when starting, continuing, or stopping opioids. Each module offers free continuing education and includes clinical scenarios and tools and a resource library to enhance learning. The entire series can be found on our Training for Providers webpage.

Medicines Risk Fact Sheet

CDC recently released some new tools to help older adults identify medicines, including opioids that cause side effects and increases the risk of a fall or motor vehicle crash. This fact sheethelps patients to identify medicines that put them at risk, potential side effects, and questions they can ask their doctor. The medicines fact sheet and two documents (Personal Medicines List & Personal Action Plan) that can help patients list their personal information can be downloadedhere.

Webinar: Evidence-Based Strategies for Preventing Opioid Overdose

The National Center for Injury Prevention and Control of the Centers for Disease Control and Prevention and the Center for Faith and Opportunity Initiatives at the Department of Health and Human Services will host a webinar featuring community practitioners engaged in programs for harm reduction, treatment initiation, and provider education. Presenters will discuss their work and the efforts that went into successfully implementing their programs.

When: May 29, 2019 from 12:00-1:30 PM EDT
URL: https://zoom.us/webinar/register/656f994c7b4fc36b34538d7d4481ef37
Call-in Access: 1-929-205-6099
Webinar ID: 226961046
POC: Melissa Podolsky (oex0@cdc.gov)

Recent Articles and Publications

1. Drug Overdose Deaths Involving Cocaine and Psychostimulants with Abuse Potential – United States, 2003-2017

This MMWR report analyzes the demographic variation of drug overdose deaths involving cocaine and psychostimulants, showing increases in death rates involving cocaine and psychostimulants (e.g., methamphetamine) across age groups, racial/ethnic groups, county urbanization levels, census regions, and multiple states examined in this study from 2016-2017. Death rates involving cocaine and psychostimulants with and without opioids have increased. Synthetic opioids appear to be the primary driver of cocaine-involved death rate increases, and recent data point to increasing synthetic opioid involvement in psychostimulant-involved deaths. Increases in deaths involving cocaine and psychostimulants in recent years with and without opioids illustrates the growing complexity of the current overdose crisis. The relationship between stimulants (like cocaine and psychostimulants) paired with opioids is a growing problem that will require an increase in public health and data collection efforts in order to implement comprehensive, evidence-based drug overdose prevention.

2. Suspected Heroin Overdose in U.S. Emergency Departments (2017-2018)

Overdose deaths involving opioids have quadrupled since 1999. A recent study analyzed emergency department (ED) data from CDC’s Enhanced State Opioid Overdose Surveillance (ESOOS) program to understand changes in suspected heroin overdose from 2017-2018. Overall there was a significant yearly decrease of 21.5% in heroin overdose ED visits in the 23 ESOOS states. Subsequently, this report highlights the importance of using ED data as an early warning system for communities to better monitor and respond to overdoses.

3. Evaluation of a Safer Opioid Prescribing Protocol (SOPP) for Patients Being Discharged from a Trauma Service

A recent study evaluated the Safer Opioid Prescribing Practice Protocol (SOPP) implemented at a Level 1 trauma center for patients diagnosed to go home with a prescription for opioid medication after an inpatient admission between 2014 and 2016. The protocol was integrated into an existing electronic health record system as an electronic best practice alert. Implementation of the protocol into Level 1 Trauma Centers increased the use of non-opioid pain medication; decreased dispensing of high opioid dose medication (≥ 100 MME), increased the delivery of opioid safety education to patients, and initiated naloxone prescribing.

4. CDC Advises Against Misapplication of the Guideline for Prescribing Opioids for Chronic Pain

The CDC Guideline for Prescribing Opioids for Chronic Pain was developed to ensure that primary care clinicians work with their patients to consider all safe and effective treatment options for pain management. In a recent New England Journal of Medicine article, authors advise againist the misapplication of the Guideline that can risk the patients’ health and safety. A few examples of misapplication of the guideline along with and recommendations for safe and effective implementation of the guideline are included in this article. You can learn more here.