We are facing a crisis in overdose deaths in Philadelphia and around the country. In 2014, more than 47,000 people in the United States died of drug overdoses, more than double the number of fatal drug overdoses in 2000. In 2019, 1,150 people died from drug overdoses in Philadelphia. Eighty percent (80%) of these overdose deaths involved opioids.
The City, including the Philadelphia Department of Public Health and the Department of Behavioral Health and Intellectual disAbility Services, are using several approaches to reduce opioid overdoses. This page contains resources and guidance for healthcare providers on limiting use of prescription opioids and avoiding adverse consequences.
Opioid Overdose Notification Network
Maintained by the Philadelphia Department of Public Health, the Opioid Overdose Notification Network is a network of government, healthcare and community partners involved in combating the opioid epidemic. These individuals receive notifications about major surges in overdoses and will be expected to share this information with key staff at their facility. They will also be asked to report spikes and/or unusual observations to the Division of Substance Use Prevention and Harm Reduction at the Health Department.
Click here to sign up for the Opioid Overdose Notification Network.
Health Alerts, Advisories, Notifications, and Updates
- PDPH Advisory: Emergency Department Reporting Requirement - Drug-Related Visits - July 6, 2020
- PDPH Notification: Neonatal Abstinence Syndrome Reporting Requirement in Philadelphia - February 26, 2019
- PDPH Advisory: Fentanyl Overdose Events Associated with Smoking Crack Cocaine - June 26, 2018
- PDPH Alert: Carfentanil Detected in Suspected Drug Overdose Deaths in Philadelphia - July 11, 2017
- PADOH Advisory: Extreme Danger Posed by Carfentanil - January 17, 2017
- PDPH Update: Increases in Suspected Overdoses in Philadelphia - December 12, 2016
- PDPH Update: Opioid and Benzodiazepines Prescribing Guidelines - December 2, 2016
- PDPH Alert: Overdose Outbreak in Philadelphia - November 18, 2016
- CDC Update: Influx of Fentanyl-laced Counterfeit Pills and Toxic Fentanyl-related Compounds Further Increases Risk of Fentanyl-related Overdose and Fatalities - August 25, 2016
- PADOH Advisory: Pennsylvania’s Prescription Drug Monitoring Program – Additional Tools and Resources - August 22, 2016
- PDPH Advisory: Sharp Increases in Overdoses Involving Fentanyl - August 19, 2016
- PADOH Advisory: Pennsylvania’s Prescription Drug Monitoring Program - August 9, 2016
- CDC Advisory: Increases in Fentanyl Drug Confiscations and Fentanyl-related Overdose Fatalities - October 26, 2015
Guidelines for Opioid Prescribing
The Philadelphia Department of Public Health (PDPH) and Department of Behavioral Health and Intellectual disAbility Services (DBHIDS) developed opioid prescribing guidelines for healthcare providers to use when considering prescribing opioids and benzodiazepines. Click here to view the opioid prescribing guidelines (Updated: 08/20/17), which include opioid prescribing, chronic pain treatment, and benzodiazepine prescribing.
The key points of the opioid prescribing guidelines are listed below.
Limiting Use:
- Do not prescribe opioids as first-line or routine therapy for chronic pain
- Discuss benefits, risks, and side effects of opioid therapy (e.g., addiction, overdose)
- Set realistic and measurable goals for pain and function
- Use short acting opioids when starting opioid therapy for chronic pain
- Prescribe the lowest effective dosage when starting opioid therapy
- When using opioids for acute pain, prescribe short-acting forms and no more than necessary; three days or less is usually sufficient.
Avoiding Adverse Consequences:
- Follow-up regularly to re-evaluate risk of harm and reduce dose or taper if needed.
- Prescribe naloxone for individuals who are undergoing long-term opioid therapy.
- Check Prescription Drug Monitoring Program (PDMP) portal.
- Use urine drug screening to identify prescribed substances and undisclosed use of other drugs.
- Avoid concurrent benzodiazepine and opioid prescribing.
- Arrange treatment for opioid use disorder if needed, including medication-assisted treatment (buprenorphine or methadone).
- Consider incorporating buprenorphine treatment into your own practice.
To access additional guidance and opioid-related reports, click here.
Reporting
- Beginning April 13, 2020, City law and regulations promulgated by the Philadelphia Board of Health require emergency departments to report aggregate data quarterly to the Philadelphia Department of Public Health related to all encounters for drug-related conditions (overdose or withdrawal symptoms).
- Aggregate data should be reported using this secure online report form.
Surveillance
Prescription Drug Monitoring Program
The Pennsylvania Department of Health has launched a Prescription Drug Monitoring Program (PA PDMP) to increase the quality of patient care by giving prescribers and pharmacists access to their patients’ controlled substance prescription history. All schedule II-V prescriptions dispensed to outpatients, including opioids and benzodiazepines, are collected by the PA PDMP no later than the close of the subsequent business day of dispensing the controlled substance.
Resources
Updated: 07/07/2020 10:00am