1. 1 Prescribing Pain Medication – Guidelines for the Emergency Department April 22, 2012 Jennifer Sabel, PhD

2. 2 Interagency Workgroup to Prevent Prescription Opiate Misuse, Abuse and Overdose Began quarterly meetings in June 2008 Includes representatives from: Workers Compensation System, Medicaid & Mental Health, Medical boards/commissions with prescriptive authority, health plans, emergency room physicians, Washington Poison Control Center, Attorney General's Office & law enforcement, UW-Harborview and Alcohol and Drug Abuse Institute Developed short-term actions Increase provider and public education. Identify methods to reduce diversion through emergency departments. Increase surveillance. Support evaluation of practice guidelines for providers treating chronic, non- cancer pain patients with opioids and the prescription monitoring program.

3. 3 Emergency Department Specific Activities Guidelines for Opioid Prescribing Information Exchange Shares patient information between EDs, focus frequent ED visitors

4. 4 Emergency Department Specific Activities Guidelines for Opioid Prescribing Adopted and distributed by WA chapter of American College of Emergency Physicians http://washingtonacep.org/painmedication.htm http://washingtonacep.org/painmedication.htm Accompanied by patient education poster http://here.doh.wa.gov/materials/prescribing-pain-medication http://here.doh.wa.gov/materials/prescribing-pain-medication Information Exchange Shares patient information between EDs, focus frequent ED visitors

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6. 6 Statewide ED Visit Network April 2012

7. 7 WA Medicaid Approaches to Curbing ER Use

8. 8 The Seven Best Practices Exchange patient information Patient education about use of ED Patient review & coordination (PRC) client information/identification PRC client care plans Adopt ED opioid prescribing guidelines Use prescription monitoring program Use of feedback information 8

9. 9 Statewide ED Visit Network December 2012

10. 10 Emergency Department Opioid Prescribing to Washington State Medicaid Clients Guidelines Disseminated

11. 11 Emergency Department Opioid Prescribing to Washington State Medicaid Patient Review and Coordination Clients

12. 12 Summary Impetus came from emergency department physicians Guidelines were a collaborative effort Opioid prescribing from EDs to Medicaid clients appears to be declining

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