By Kathryn Reed

Barton Health officials endorse the guidelines passed this month by the Centers for Disease Control and Prevention related to prescribing opioid painkillers such as OxyContin and Percocet.

The recommendations focus on the use of opioids for pain that has lasted longer than three months. It does not address those using these drugs for cancer or end-of-life care.

The federal initiative targets primary care physicians because in the United States they are the ones who write almost half of the scripts for opioid painkillers.

The South Shore-based health care system was ahead of the curve. In May 2014, Barton spearheaded a movement to bring a new perspective to prescribing opiates. Local emergency physicians committed to:

·         Working closely with community physicians to coordinate care of patients with chronic pain.

·         Identifying people with chronic pain and refer them to additional support from their primary care provider and/or a chronic pain specialist.

·         Identifying high risk behavior and use that information in our prescribing practice.

Many states already have guidelines for such drugs.

“All hospitals and pharmacies in California and Nevada have policies to regulate prescribing and filling prescriptions of opioids. Barton Health has guidelines for dose based on an individual patient’s pain level or condition, effective pain management strategies, and ways to enhance our patients’ comfort and function,” Rhonda Sneeringer, chief medical officer for Barton Health, told Lake Tahoe News. “We take a collaborative, interdisciplinary approach to pain management and work with the providers, patient, and – when appropriate – the patient’s family to find a functional, positive quality of life for each patient that may or may not include opioids.”

Because opiates may lead to complications, including death, Barton uses non-addictive treatments as well. These include other drugs, acupuncture, aromatherapy, physical therapy, relaxation therapy, and yoga.

“We have also been working hard to address underlying issues that may be causing additional pain, such as substance abuse, mental health issues, stress, or a chronic disease,” Lance Orr, medical director for Barton’s Emergency Services, told Lake Tahoe News.

The stated need for the guidelines is because of the high rate of addiction. The CDC said opioid prescriptions reached 259 million in 2012.

Sneeringer added, “Our goal is to help people get back to optimal health measured by function and quality of life, which includes managing level of pain, but not focused solely on becoming pain-free.”

Barton plans to hire a pain management specialist to work directly with patients.

Sen. Dianne Feinstein, D-Calif., in a statement, said, “The guidelines released by CDC are an important first step in combating the overuse of opioid painkillers, which is one of the root causes of the heroin epidemic in this country. The agency noted that no other medication regularly used to treat nonfatal conditions kills patients as frequently as opioids.

“In too many cases, opioids have become the default response for pain, even when alternatives are available. The guidelines will help doctors determine whether to start or continue opioids for treatment of chronic pain, as well as proper dosing and follow-up. They will also encourage greater use of evidence-based treatment.”

Feinstein was one of eight senators who in November urged the CDC to finalize strong guidelines to address overprescribing.