Prescribers Care Resources

RESOURCES FROM MAY 2024 PRESCRIBERS CARE DISCUSSIONS:

Resources from May 9, 2023 Prescribers Care Discussion:

Self-Guided Resources

In-House Resources

  • Substance Use Treatment Access Line: 1-866-998-2243
  • MAT Clinic (requires DMC-ODS referral)
  • Irving Rosenstein, PA-C
  • Vora Volf, PharmD

Table of Contents

Prescribers Care Discussion Series Resources

  1. Session 1: What Prescribers Need to Know About Illicit Fentanyl
  2. Session 2: Evidence-based Safe Prescribing
  3. Session 3: Deprescribing is Good Prescribing
  4. Session 4: Person-Centered Strategies to Reduce Opioid Overdose

Additional Resources

  1. Patient Communications
  2. Cures 2.0 Prescription Monitoring
  3. Prescribing Best Practices
  4. Naloxone Mandate
  5. Treatment

Dental Prescribing Resources

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What Prescribers Need to know about Illicit Fentanyl

 

Legislation >

  

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Evidence-Based Safe Prescribing

  

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Deprescribing is Good Prescribing

 

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Person-Centered Strategies to Reduce Opioid Overdose

  • ‍Mother & Baby Substance Exposure Toolkit: nastoolkit.org‍
  • ‍American Society of Addiction Medicine, National Practice Guideline 2020 Focused Update: asam.org‍
  • ‍Perinatal Substance Use Services: vchca.org‍
  • ‍HIV Prep – Preexposure Prophylaxis for the Prevention of HIV Infection in the United States – 2021 Update: cdc.gov (PDF)
  • ‍CDC – HIV Prevention Information Page: cdc.gov‍
  • ‍Never Use Alone National Hotline
    neverusealone.com
    800-484-3731‍
  • ‍Hepatitis C Medication List: hepatitis.uw.edu
Guidelines for Safe Opioid Rx →
Common Street Drug Terms →

additional Resources

PATIENT COMMUNICATIONS

Handout – Prescription Opioids: What You Need to Know, Centers for Disease Control and Prevention – Ventura County versions

Handout – Pregnancy and Opioid Pain Medications, Centers for Disease Control and Prevention

‍Website –  Opioid Overdose, Information for Patients, Centers for Disease Control and Prevention ‍

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Decals – We Check Because We Care, Ventura County Health Care Agency
Patients, family members and prescribers all benefit from messaging starting at the clinic door. Contact us for more information about materials.
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What You Can Do to Prevent Opioid Overdose
See the "Talking to Your Doctor" video

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CURES 2.0 PRESCRIPTION MONITORING

The Controlled Substance Utilization Review and Evaluation System (CURES) contains information about whether other clinicians have prescribed controlled substances to your patient. This type of information can help prescribers make informed decisions and avoid duplicate or additive types of medications from being provided to patients. The mandate to consult CURES prior to prescribing, ordering, administering, or furnishing a Schedule II-IV controlled substance became effective on October 2, 2018.

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PRESCRIBING BEST PRACTICES

The following evidence-based interventions also lower overdose death rates:

  • Avoid co-prescribing an opioid and a benzodiazepine. Nationally the number of opioid deaths involving benzodiazepine is increasing annually.
  • Minimize opioid prescribing for acute pain. According to the Centers for Disease Control and Prevention (CDC), clinicians should avoid opioids, and when necessary, start with the lowest effective dose of immediate-release opioids. Three days or less will often be sufficient. Opioids should not be considered first-line or routine therapy for chronic pain.
  • Taper opioids to safer doses. The CDC recommends that for patients already on long-term high dose opioid therapy, taper to a dose that is lower than 50 milligrams of morphine equivalent. Slow opioid tapers as well as pauses in the taper may be needed for long-term users. ‍
  • Avoid “the 90-day cliff.” The CDC recommends opioids should be discontinued if benefits do not outweigh risks

RESOURCES:

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NALOXONE MANDATE

The CDC recommends prescribing naloxone to patients on higher than 50 milligrams of morphine equivalents daily. The mandate to offer a prescription for naloxone to a patient at high risk of overdose became effective January 1, 2019.

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TREATMENT

Prescription Opioids: What You Need to Know →
CDC Guidelines: Tapering Opioids for Chronic Pain →

Dental prescribing Resources

Teens who are prescribed opioids after their wisdom teeth are removed have a 33% higher risk of opioid misuse later in life.
"Dentists play a pivotal role and have a professional responsibility to reduce the misuse and abuse of opioids..."
– California Dental Association
"One in 16 prescribed opioids after a surgical procedure will become a long-term user."
– International Journal of Oral & Maxillofacial Surgery
5 days of opioid use can lead to dependence.

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Resources

Statement on the Use of Opioids in the Treatment of Dental Pain, American Dental Association

Dental Pain May Lead to First Encounter with Opioids, Centers for Disease Control and Prevention

CURES and Opioid Pain Management, California Dental Association

Patient Handout: Prescription Opioids: What You Need to Know, Centers for Disease Control and Prevention – Ventura County versions

Form: Consent to Prescribe Opioid to a Minor, California Dental Association

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