In early 2013, the MMA began discussions on the public health crisis of opioid abuse, misuse and diversion with a focus on what the Association might do to assist physicians to become more knowledgeable of the changing best medical practices when treating patients with chronic pain, and encourage cooperation with local law enforcement officials on concerns of possible diversion.

Later that year, the MMA determined the topic demanded the creation of a work group that would bring together physicians with expertise in this area, physicians engaged in practice changes to address the issue and other stakeholders. The MMA Committee on Prescription Drug Abuse was officially launched in January 2014 with nearly 20 physician members and has since met on a regular basis to share their expertise, which laid the groundwork for a framework as described below.

Statistics caught the attention of physicians and those physicians working to address this issue specifically set an overarching goal to decrease the number of overdose deaths in Montana. Statistics from the Centers for Disease Control & Prevention (CDC) note that enough prescription painkillers were prescribed in 2010 to medicate every American adult around-the-clock for one month. Approximately, three out of every four pharmaceutical overdose deaths in 2010 were due to opioid analgesics like oxycodone, hydrocodone and methadone. Medicaid patients are prescribed painkillers at twice the rate of non-Medicaid patients and are at six times the risk of prescription painkiller overdose. And unintentional overdose deaths related to prescription opioids have quadrupled since 1999—and now outnumber those from heroin and cocaine combined. It has been further noted that within the world of workers’ compensation, there is significant proof that long-term opioid use leads to longer claim duration, longer-term disability, higher costs and higher medical expenses.

Clearly, this issue is deserving of a statewide, multi-stakeholder approach as it reaches beyond the physician office doorway. The consequences impact our families and friends, the communities we live in, and our workplaces. The issue needs to be tackled from both a supply-side and demand-side, and strategies must grow from a framework that is directed at health care providers, patients, law enforcement and the general public. The MMA has expanded its work group to include other stakeholders and offers the below framework to describe how best to engage physicians and to offer action steps to start addressing the issue.

To read the entire MMA White Paper on the subject, please click here.