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New initiative is reducing the amount of prescription drugs in circulation

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A new effort to fight the opioid crisis in our state is making a significant dent in the number of prescription opioids in circulation.

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The Better Prescribing, Better Treatment Initiative was launched late last year and is part of the state’s Opioid Response Plan.

It’s a team effort between the Washington State Medical Association, Washington State Hospital Association, and the state Health Care Authority, as an effort to reduce the number of prescription opioids making their way into communities. And the eventual goal?

“To really work together to tackle the opiate epidemic by creating guidelines and then feedback to providers to help improve the quality of care that we’re delivering around opioid prescribing in the state,” said Dr. Nathan Schlicher a Tacoma ER doctor who helped create the initiative.

The initiative encourages prescribing doctors to follow new state Apple Health (Medicaid) guidelines for prescribing opioids, which limit the number of opioids doctors prescribe for acute – or temporary – pain to just a three-day supply, 18 pills, for those 20 and younger – and just a seven-day supply (42 pills) for adults.

“It’s really trying to go after that initial prescription because we do know that the longer you’re on an opiate for that first prescription the more likely you are to be in it in one and in three years,” Schlicher said.

Schlicher says less than a year after the program launched they’re seeing great results.

“We were able to make dramatic improvements in compliance with these guidelines. We dropped the number of non-compliant, or non-conforming scripts by almost 65 percent, and as we’ve done that I think a lot of providers have also re-evaluated whether or not they want to and need to prescribe opiates, and we’ve seen a drop in the number of acute pain prescriptions by almost 2,500 per quarter. That means there are about 10,000 less prescriptions out there in Washington.”

Schlicher says that’s huge because this is a numbers game.

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“We know from SAMSA (Substance Abuse and Mental Health Services Administration) data that 75 percent of opiates that people try for the first time come from friends, family or relatives that they’ve bought, or stolen, or been given,” Schlicher said.

“There’s a real problem with of numbers out there in the community. We believe that by getting these prescriptions down to the appropriate number, people using what they need, and then hopefully working on take-back programs that the Legislature passed last year, we can reduce that supply.”

Also helping drive down these opioid prescription numbers is the peer-to-peer data-sharing aspect included in this initiative — where doctors talking part in the program get to see not only how often they’re meeting those prescribing guidelines, but how their prescribing habits compare to other doctors through a physician feedback program.

“We doctors are known to be a slightly competitive breed of human beings, so ‘I don’t have to be first but I definitely don’t want to be worst’ is what we often hear,” Schlicher said.

Right now, there are about 20 health programs in our state taking part in the Better Prescribing Better Treatment initiative, which represents some 11,000 Apple Health prescribers in the state, and it is spreading beyond just Medicaid patients.

Schlicher hopes to see it expand statewide. “That’s my dream and my vision, you know, is that we will get there to have every provider enrolled and continue to work on making us all have better practices and down the road I think we’ll see that.”

This program is in addition to new state rules covering opioid prescribers that are set to be implemented in the fall, according to the Health Care Authority.

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