Amida Care Supports New CDC Guideline for Opiod Use

As you may know, in March 2016 the Centers for Disease Control and Prevention (CDC) published a guideline for the use of opioids in the treatment of chronic pain. Amida Care has been aware of the risks to New Yorkers from opioids. We welcome this guideline as an additional resource for providers. The information here highlights the goals of the guideline and contains a link to the complete document.

Amida Care supports the three goals of the guideline as stated on the CDC website:

• Determining when to initiate or continue opioids for chronic pain outside of active cancer treatment, palliative care, and end-of-life care
• Opioid selection, dosage, duration, follow-up, and discontinuation
• Assessing risk and addressing harms of opioid use

Recommendations are for the prescribing of opioid pain medication for patients 18 and older in primary care settings. The recommendations focus on the use of opioids in treating chronic pain (pain lasting longer than three months or past the time of normal tissue healing). Please note that the guideline does not cover pain from active cancer treatment, palliative care, and end-of-life care.

By working together to improve the way opioids are prescribed, we can support patients with access to safer, more effective chronic pain treatment. Another benefit will be reducing the number of our members — your patients — who misuse, abuse, or overdose from these drugs.

The CDC guideline is publicly available at CDC Guideline for Prescribing Opioids for Chronic Pain. Amida Care is working to improve the health of its members by ensuring opioids are prescribed for appropriate indications, at safe doses, and in conjunction with other pain management treatment strategies. Our goal is to discourage dose escalation for patients already on high doses and to assist our providers with prescribing opioids safely and appropriately.

Phase I – Quantity Limits
The first phase of our initiative was implemented on June 1, 2016. Quantity limits were placed on all narcotic analgesics in order to encourage appropriate drug use in accordance with the 2016 CDC Opioid Prescribing Guidelines. Prescriptions for greater quantities than the QL may be reviewed for medical necessity through the Prior Authorization Process.

Phase II
The second phase will occur later this year and will include:

• Morphine Equivalent Dosing (MED) quantity limits
• Prior authorization of long-acting opioids for all new starts
• Per NYS DOH Mandate: Limit the number of opioid prescriptions to four (4) prescriptions per 30 days (except diagnosis of cancer or sickle cell disease).