AK Public Health Alert Network: Opioid Health Action Response to the Arrest of Two Alaskan Opioid Prescribers

Alaska DOH sent this bulletin at 10/16/2019 02:22 PM AKDT

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Alaska Public Health Alert

Opioid Health Action Response to the Arrest of Two Alaskan Opioid Prescribers

October 16, 2019

Summary

Following the arrest this week of two opioid prescribers in Alaska by the U.S. Drug Enforcement Administration (DEA), the Alaska Department of Health and Social Services (DHSS) is coordinating with Alaska’s medical community and state, local, federal, and tribal partners to assist in addressing the physical and behavioral health needs of patients with discontinued prescriptions and those in need of a new primary care provider. We are concerned that patients previously under the care of these clinicians are at risk for opioid overdose and withdrawal. The purpose of the Health Alert Network message is to provide a consolidated list of resources for impacted clinicians, patients, families, and communities.

Currently available data indicate that the two providers in question served approximately 2,000 patients, some of whom live in remote parts of Alaska. Because the DEA registrations and professional licenses for these two prescribers have been surrendered, opioid (and other) prescriptions from these clinicians will not be filled by pharmacies. We recognize that this challenging situation is compounded by the fact that Alaska is already facing a shortage of primary care providers and a concomitant shortage of clinicians available to treat chronic pain and substance misuse.

For more background information on this situation, please refer to the following resources:

DHSS information specific to clinicians and pharmacists issued on October 11 http://dhss.alaska.gov/dph/Director/Documents/opioids/factsheet.pdf
DHSS press release on this topic issued on October 11
DHSS webpage on this topic: http://dhss.alaska.gov/dph/Director/Pages/opioids/news.aspx

Clinically-Supported Advice for Providers

Clinicians can access free clinically-supported advice from a Health Resources & Services Administration (HRSA) substance use management consultation center, which includes direct access to addiction specialists (including specific support for obstetric and pediatric patients).
- Call 1-855-300-3595
- Hours of operation: Monday – Friday, 9 a.m. to 8 p.m. EST
- Website: http://nccc.ucsf.edu/clinician-consultation/substance-use-management/

Overdose Prevention

In some cases, anticipation of withdrawal can cause people to obtain opioids through other means, such as black market prescription opioids made to look like common medications (e.g., Percocet and oxycodone). These medications can vary widely in dosage and can contain fentanyl or other substances, elevating the risk for overdose and other medical emergencies. To learn more about how to prevent an opioid overdose, visit the DHSS Project Hope website.
Clinicians are also encouraged to co-prescribe naloxone to patients who are at high-risk for an opioid overdose or who receive high-dose opioids. https://www.hhs.gov/about/news/2018/12/19/hhs-recommends-prescribing-or-co-prescribing-naloxone-to-patients-at-high-risk-for-an-opioid-overdose.html

Pain Management Resources

Alaska State Medical Board-issued Guideline Regarding Prescribing Controlled Substances: www.commerce.alaska.gov/web/cbpl/ProfessionalLicensing/StateMedicalBoard/BoardGuidelinesPolicies.aspx
CDC Guideline for Prescribing Opioids for Chronic Pain: www.cdc.gov/drugoverdose/prescribing/guideline.html
When applicable, clinicians are encouraged to consult the Health and Human Services Guide for Clinicians on the Appropriate Dosage Reduction or Discontinuation of Long-Term Opioid Analgesics
Additional resources for Alaska clinicians on opioids and pain management can be found at: http://dhss.alaska.gov/dph/Director/Pages/opioids/prescribers.aspx
The Opioids in Alaska website offers information on opioids education, preventing opioid overdose with naloxone, non-opioid pain management and more.

Resources for Patients

There are free and confidential resources for patients who may need assistance with prescriptions or finding an appropriate health care provider:

Call 9-1-1 if there is a life-threatening emergency.
Call 2-1-1 to find supportive services through the United Way.
- 2-1-1 provides information and referral services that connect people to community, health, and social services provided by nonprofit, governmental, and tribal agencies.
- Operational hours are 8:30 a.m. – 5 p.m., Monday – Friday. If you call after hours, please leave a message. Phone calls will be returned the next business day.

SAMHSA has a national helpline to assist with finding behavioral health support or substance use management, 800-662-HELP (4357), TTY: 800-487-4889. These calls are staffed 24/7 and are routed to the DHSS Division of Behavioral Health during DHSS operational hours.
Call 1-877-266-4357 for immediate and confidential mental health assistance 24/7 through the Alaska CARELINE.
Community-specific Alaska suicide prevention hotlines are available at: http://www.suicide.org/hotlines/alaska-suicide-hotlines.html

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