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Putting a Stop to the Opioid Abuse Crisis

Montana’s children have one of the nation’s highest rates of prescription drug misuse in the country

By Patrice A. Harris and N. Camden Kneeland

The opioid epidemic confronting the nation is leaving few areas untouched, including here in Montana where families know too well the tragic effects of opioid addiction.

Montana’s children have one of the nation’s highest rates of prescription drug misuse in the country; almost 10 percent of youth aged 12 to 17 have reported misusing prescription pain relievers.

According to the Montana Department of Health and Human Services, from 2011 to 2013, prescription drug overdoses took the lives of more than 360 Montanans.

That is why the Montana Medical Association (MMA) partnered with the state’s attorney general and colleagues in the insurance industry to create the Know Your Dose campaign to help educate patients and physicians and other health professionals about ways to reverse this epidemic.

Big Sky Country is a great example of how states – with elected leaders collaborating with those in the medical community – can develop real-world solutions. As physician leaders, we are unequivocal in saying that we must do what is necessary to reverse this epidemic, and Know Your Dose provides practice- and policy-related solutions that will make a difference.

And we are making a difference.

Although the Montana Prescription Drug Registry could be improved, Montana physicians made 42 percent more inquiries to it in 2015 compared to 2014, checking it nearly 160,000 times. The registry contains helpful information on whether a patient is receiving multiple prescriptions from multiple pharmacies. We need it to more easily integrate into our practices and connect with our electronic health systems, but physicians are committed to using it as part of the clinical decision-making process.

Thanks to the MMA and its partners, Montana’s physicians can enroll at no cost for a pain management course designed to help medical professionals provide the best treatment for their patients, while preventing them from becoming addicted to opioids. We urge all Montana physicians who prescribe controlled substances to go to knowyourdosemt.org and take this course.

Other resources are available at the click of a mouse. The Know Your Dose campaign provides excellent educational resources for patients, physicians and other health professionals, including resources on managing chronic pain.

Resolve Montana is an educational campaign developed by the state Attorney General’s Office that illustrates why it is vital to use medications as instructed, to safely store and dispose of unused medication, and how to recognize signs of a potential substance use disorder. Importantly, it aims to reduce the stigma associated with having a substance use disorder by emphasizing the importance of treatment. If you or someone you know has a substance use disorder, talk to your physician today about getting help.

For our part, we understand the tremendous national interest in reducing the supply of opioids. We know prescribed medications wind up being used by someone other than the intended patient, as more than 70 percent of the individuals misusing opioids are getting opioids from other sources, including friends or family members. From 2013 to 2015, Montana’s physicians have decreased opioid prescriptions by 10.6 percent. Montanans have a proud history of judicious use of resources and are taking that philosophy to how opioids are prescribed.

These steps will help reverse the course of the epidemic, but we also must put increased energy into two key places. We need to ensure that our patients with pain receive comprehensive – and compassionate – treatment. While the nation’s opioid supply will almost certainly continue to decrease, we need to ensure that we continue to work with our colleagues in the insurance industry to provide patients with a full range of evidence-based, non-opioid and non-pharmacologic treatments.

Similarly, patients with a substance use disorder need treatment just like for any other chronic, relapsing medical condition. We would never put treatment limits or prior authorization restrictions on diabetes care or heart disease, so we need to ensure our patients with substance use disorders have access to affordable, timely care that does not run out or is financially beyond their reach.

Another key element to saving lives is for our state to enact laws that increase access to naloxone and provide strong Good Samaritan protections to those who help someone experiencing an overdose. Montana is one of only a few states without naloxone access provisions. These laws have helped save tens of thousands of Americans. It’s time for Montana to enact these laws.

Montana has made progress. The state has stepped up to lead a strong, diligent fight against opioid misuse, overdose and death. We must continue the positive trends – and work even harder.

The American Medical Association is proud to support the work of the MMA and other leaders in this critical effort. The lives of our patients depend on it.