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 Philadelphia, this growth has been particularly stark over the last two years: fatal drug overdoses increased by more than 50% from 2013 through 2015, from approximately 459 deaths to approximately 702. In 2015, there were more than twice as many deaths from drug overdose in Philadelphia as there were from homicide. 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.

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


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.

Click here to register for the PA PDMP.

Resources

Conferences

The Department of Behavioral Health and Intellectual disAbility Services (DBHIDS) hosted a conference in September 2016 focused on buprenorphine. The purpose of this conference was to promote effective models for delivering buprenorphine as a medication-assisted treatment into various treatment settings, including primary care and other medical settings. Click here to view slides from the buprenorphine summit courtesy of the DBHIDS.

There are no additional conferences related to the overdose crisis planned at this time. Please check back here regularly and click here for information on other upcoming conferences.

Updated: 09/12/2017 5:00pm