Play 3: Reduce the use of opioids for pain mitigation

A clear consensus has emerged that one very important way to reduce the use and misuse of legal and illicit drugs is to control and limit opioid prescriptions for pain management. In a real sense, the eventual goal of this ambitious play is to change the culture of pain management. It requires a substantial educational effort for physicians and patients about the risks and cautions in opioid use for this purpose.

Activities that have been successfully implemented (these are from the Chronic Pain Initiative in North Carolina) include promotion of a targeted toolkit for primary care providers, emergency departments and care managers; continuing medical education sessions on pain management; appropriate prescribing and diversion control and continuing education for pharmacists on diversion, forgery and the use of Prescription Drug Monitoring Programs.

Example: The California Statewide Opioid Safety (SOS) Workgroup promotes safe prescribing guidelines and disseminates educational materials, such as one for health care providers.

Goals and Objectives
The basic goal of this strategy is simply to reduce the quantity of opioids prescribed for long-term pain management, following guidelines to limit the use of opioids for this purpose.

Measurable objectives can be constructed along the lines of making a percentage decrease in the number of opioid prescriptions filled that are for longer than a specified time period.

Theory of Change
Reducing the number of long-term prescriptions will result in fewer people becoming addicted to opioids beyond pain management, thereby reducing the addiction rate and, in particular, overdoses resulting in death.