West Virginia Attorney General Patrick Morrisey Approves Best Practices Guidelines

PARKERSBURG — An initiative intended to reduce addictions to prescribed opioid medications has been approved by the West Virginia Attorney General’s Office.

“We want this to become the standard of care,” state Attorney General Patrick Morrisey said Friday.

Best Practices for Dispensing Opioids in West Virginia, which has been under discussion by the attorney general’s office and representatives of health care groups in West Virginia, are guidelines for prescribers and dispensers of opioid prescriptions. The aim of the guidelines is to eliminate or reduce misuse, while enabling patients with medically legitimate needs to access the medications.

“Opioids should not be the first line of therapy options,” Morrisey said.

West Virginia ranks in the top of states with the highest rate of deaths from prescription drug killers, 35.5 per 100,000 residents, a rate that is twice the national average. Of the 686 overdose deaths in 2015, nearly 600 were opiate-related overdoses.

The plan was unveiled in May with its development from a holistic approach, Morrisey said.

Among guidelines are those urging:

∫ pharmacists to check the legitimacy of the patient, prescriber and prescription besides ensuring the medication, dose, quantity and any mix with other medications is safe;

∫ prescribers to monitor a patient’s opioid drug usage;

∫ tests to find misuse; and

∫ that patients be made aware of the risks of opioid treatment.

They recommend a screening and consideration first of non-opioid alternatives.

The guidelines do not affect patients on cancer treatments or palliative and end-of-life care.

An obstacle will be to change the culture and mindset, Morrisey said. The financial incentives to prescribe opioids also has to change, he said.

“We’re trying to make fundamental changes,” Morrisey said.

While up front it is more profitable, it is costly in the long run to treat the addiction, Morrisey said. Also, opioid addiction can lead to other addictions, he said.

“We know it’s a pathway to heroin,” Morrisey said.

Efforts are also underway to educate people, too, about the dangers of using opioid medications, Morrisey said. He and Ohio Attorney General Mike DeWine have met with community groups in public forums on that aspect of fighting the problem, including their Thursday town hall-style event in Wheeling.

The initiative, the first of its kind in West Virginia, Morrisey said, has support from numerous groups in the state and nation, including the American Medical Association, American Osteopathic Association, West Virginia State Medical Association, West Virginia Osteopathic Medical Association, West Virginia Society of Health System Pharmacists and boards representing dentistry, occupational therapy, chiropractic and acupuncture, the Board of Examiners in Counseling and the Massage Therapy Licensure Board.

“The AMA shares your belief that primary prevention and public education are key components of a public health plan to halt the epidemic and protect future generations,” Dr. James Madara, executive vice president and CEO of the American Medical Association, said. “It is a tragic understatement to say that generations of families have been affected by opioid misuse, overdose and death.”

The best practice guidelines underscores “the importance of all the health care providers working together to do what is best for the patient,” Holly L. Harvey, secretary for the state’s Board of Chiropractic, said.


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