Opioid Prescribing Guidelines from ICEP and IHA Now Available
Every day, an estimated five people in Illinois die from opioid-related overdoses. With overdoses surging 70 percent from 2013-16 and hospital emergency departments seeing a 66 percent increase in opioid overdose visits last year, ICEP partnered with the Illinois Health and Hospital Association (IHA) to develop Opioid Prescribing Guidelines: For Patients in the Emergency Department and Immediate Care Centers.
All emergency physicians are encouraged to discuss these guidelines with their staff and colleagues and incorporate them into daily patient care. The guidelines are meant to assist clinicians in treating patients with acute and chronic pain in the emergency department, bolstering the role of clinicians in tackling Illinois’ opioid epidemic.
The guidelines were initiated at the request of IHA’s Medical Executive Forum, a group of about 30 physician leaders across the state, in April 2017. ICEP leaders worked closely with leaders from IHA’s Institute for Innovations in Care and Quality to create both long and short versions of the guidelines.
Both versions refer to three common ED scenarios:
- Prescribing for opioid-naïve individuals with acute injuries;
- Exacerbation of chronic pain in patients receiving long-term opioid therapy; and
- Co-prescribing of naloxone and referral to medication-assisted treatment for patients at risk of overdose or with opioid use disorder.
ICEP and IHA leaders aligned the guidelines with those of the Centers for Disease Control and Prevention, American College of Emergency Physicians, American Academy of Emergency Medicine and The Joint Commission.
In addition, the guidelines align with the State of Illinois Opioid Action Plan regarding:
- Appropriate prescribing in the ED;
- Increased use of the Illinois Prescription Monitoring Program;
- Co-prescribing of naloxone for patients at risk of overdose; and
- Referral to medication-assisted treatment for patients with opioid use disorder.
Before the guidelines were finalized, two external peer reviews involved one-third of emergency department directors from IHA member hospitals. The guidelines were approved and endorsed by the ICEP Board of Directors and IHA’s Medical Executive Forum in December 2017.