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States consider opioid medical guidelines


More states are considering creating medical guidelines for doctors prescribing opioid pain medications to workers compensation claimants and other patients, said Dr. Leonard J. Pauloozi.

He is a medical epidemiologist in the National Center for Injury Prevention and Control's Division of Unintentional Injury Prevention. I interviewed Dr. Pauloozi recently while reporting a story on Washington State's controversial guidelines that appear to be reducing the number of injured-worker deaths caused by a dramatic rise in the prescribing of opioid pain medications.

Washington's guidelines provide a specific dose amount at which doctors considering prescribing the narcotic pain medications should undertake certain precautions before actually writing a prescription.

That story is available here and Dr. Pauloozi provided me with additional information I was not able to fit into that story because of magazine space considerations.

He told me that Utah has also developed guidelines that are relatively similar to Washington's.

But where Washington's guidelines provide a specific average daily morphine dose equivalent at which doctors should take additional precautions before prescribing, Utah's do not cite a specific dose amount that doctors should consider a red flag for potential dangers.

It has become clear that higher dosages of the narcotic pain medications strongly correlate with the risk of death, the doctor said. So he said it is important to have a specific measurement amount at which doctors should step back and access the additional risk before acting.

Not everyone in the medical world agrees with that.

But Dr. Pauloozi said, ”a number of studies have come out showing a significant increase in deaths with higher daily dosage.”

So in addition to Utah and Washington, New York is also considering the implementation of guidelines for doctors prescribing opioid narcotics to patients, De. Pauloozi said.

“I think there are other states that are starting to think about making recommendations to their providers,” he said.

As I mentioned in the Washington story, Colorado also has guidelines and will soon release a new version.