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Assessing the Risks of Opioid Use

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During routine drug-use management work in 2010, Kaiser Permanente Southern California leadership recognized that opioids were the most widely prescribed medications in the region.

“This finding came as quite a shock to us,” said Joel Hyatt, MD, emeritus assistant medical director of Community Health Improvement at KPSC. “It also came out at a time when the Centers for Prevention and Disease Control and Prevention had just released some of their early warnings that there was an opioid epidemic. It forced us to reevaluate and reassess what was going on in our own practice.”

Since then, people in KPSC have been working to evaluate the region’s opioid prescribing practices. Since 2010, KPSC has conducted 14 studies related to opioid use.

As a result of such studies and the implementation of KPSC’s Safe and Appropriate Opioid Prescribing Program, the region has seen marked reductions in the over-prescribing of opioids. The practices of the program, which won the 2014 KP Lawrence Patient Safety Award, have also been shared and adopted by KP regions nationally as well.

“We pride ourselves in practicing evidence-based medicine,” Dr. Hyatt added. “Evidence requires research, study, and evaluation so that we make the right clinical decisions for our patients. That is why it is so important that we continue to study the use of opioids within KPSC.”

To further our work in this area, we have recently secured funding for new grants. Below are summaries of 2 field studies with which KPSC researchers are evaluating the use of opioids.

  • Rulin Hechter, MD, PhD, is a co-investigator and site PI at KPSC for a study assessing risks associated with opioid use to learn why some people are more susceptible than others to being harmed by such drugs. 
    The Medication Use, Safety, and Evidence project is one of the largest FDA–mandated opioid studies ever undertaken, and will include a diverse population from health systems throughout the country. Study funding comes from pharmaceutical companies that manufacture extended release/long acting (ER/LA) opioids. Read more. LINK TO COME
  • As part of the Medication Exposure in Pregnancy Risk Evaluation Program consortium, Craig Cheetham, PharmD, MS, and Dr. Hechter will assess the neonatal safety of opioids when taken by pregnant women. Funded by the U.S. Food and Drug Administration, the consortium includes 8 health care organizations across the United States.
    The FDA hopes to learn more about an outcome for the fetuses of women who are exposed to opioids during the first trimester of pregnancy. The outcome of interest is neural tube defects, a severe congenital anomaly of the central nervous system. Read more. LINK TO COME