Opioid And Naloxone Prescribing Practices In Mississippi

The purpose of this study was to determine whether primary care providers (PCPs) in Mississippi are following the selected Centers for Disease Control and Prevention (CDC) guidelines published in March 2016 for prescribing opioids for chronic, non-cancer pain. The study also sought to determine if the selected providers prescribed naloxone for opioid overdose reversal. Drug overdoses have increased exponentially in the last 3 decades in the United States (Doyon, Aks, & Schaeffer, 2014) — leading to opioid overdose becoming the most frequent cause of accidental death. Opioid overdose death rates are so high the CDC declared it a problem of “epidemic” status in 2012 (Canada, DiRocco, & Day, 2014). Mississippi ranks as one of the highest prescribing states for opioid analgesics. For the purpose of this research, focus was placed on specific aspects o f the CDC guidelines as follows: (a) consider nonpharmacological treatment or treat with nonopioids first, (b) avoid prescribing opioids and benzodiazepines concurrently, and (c) check a urine drug screen prior to opioid initiation and yearly thereafter (CDC, 2016). The CDC now recommends prescribing naloxone, an opioid antagonist, to patients at risk for opioid overdose. Naloxone has demonstrated effectiveness in reducing opioid overdose mortality. A nonexperimental, quantitative, descriptive, retrospective review of charts was performed in 6 primary care clinics in Mississippi staffed by physicians and family nurse practitioners. A convenience sampling of 600 charts for retrospective chart review was conducted. Inclusion criteria were age 18 years or older, medically treated long-term with opioids (\u3e 2 prescriptions written \u3e21 days apart) for chronic non-cancer pain, and prescribed by a PCP. The findings suggested that PCPs in Mississippi are not eonsistently following CDC guidelines for opioid prescribing. It should also be noted that, of the 600 charts reviewed, none of the patients were prescribed naloxone for reversal of a potential opioid overdose. Research demonstrated a need for increased awareness and education among PCPs regarding CDC guidelines for prescribing opioids