TY - JOUR
KW - Analgesics, Opioid/adverse effects/therapeutic use
KW - Chronic Pain/drug therapy
KW - Contracts
KW - Cooperative Behavior
KW - Crime/prevention & control
KW - Humans
KW - North Carolina
KW - Opioid-Related Disorders/prevention & control
KW - Practice Guidelines as Topic
KW - Practice Patterns, Physicians'/statistics & numerical data
KW - Prescription Drugs/administration & dosage/adverse effects
KW - Primary Health Care/organization & administration
KW - Registries
KW - Rural Health Services/organization & administration
KW - Substance Abuse Detection/methods
AU - E. Bujold
AU - J. Huff
AU - E. W. Staton
AU - W. D. Pace
A1 - 
AB - OBJECTIVE: To describe the development, implementation, and effects of collaborative effort to reduce diversion of prescription drugs in Caldwell County, NC. DESIGN: Development and implementation of practice guideline, statewide opioid registry, and survey of all primary care providers. SETTING: Rural Caldwell County, NC, has a population of 83,029, of which 89 percent are non-Hispanic White; 2009 median household income of $35,489. PATIENTS, PARTICIPANTS: All primary care clinicians in the county (N = 35). INTERVENTIONS: A task force developed and implemented a practice guideline that encouraged the following: 1) signing of pain contracts; 2) requiring patients to undergo random urine drug testing; and 3) requiring random pill counts. North Carolina implemented a statewide registry in 2007 that contained information on virtually all opioid prescriptions filled by pharmacies. MAIN OUTCOME MEASURE(S): Opioid pill confiscations by the Caldwell County Narcotics Division 24 months prior to implementation of the guidelines, the first 12 months during guideline implementation, and 12 months after the guideline was fully implemented. RESULTS: From 2005 to 2007, opioid pill confiscations decreased by 300 percent. Of the 35 physicians who were sent surveys, 27 responded (77 percent response rate). Ninety percent of respondents who prescribe opioids use the chronic pain guidelines. Sixty percent report an improvement in the overall management of patients with chronic pain; 65 percent reported having more confidence in treating patients with chronic pain; and 60 percent reported using the opioid registry. CONCLUSIONS: This county wide medical initiative appears to have resulted in a significant improvement in the abuse and diversion of medically derived opioids.
BT - Journal of opioid management
C5 - Opioids & Substance Use; Healthcare Disparities
CP - 6
CY - United States
DO - 10.5055/jom.2012.0136
IS - 6
JF - Journal of opioid management
N2 - OBJECTIVE: To describe the development, implementation, and effects of collaborative effort to reduce diversion of prescription drugs in Caldwell County, NC. DESIGN: Development and implementation of practice guideline, statewide opioid registry, and survey of all primary care providers. SETTING: Rural Caldwell County, NC, has a population of 83,029, of which 89 percent are non-Hispanic White; 2009 median household income of $35,489. PATIENTS, PARTICIPANTS: All primary care clinicians in the county (N = 35). INTERVENTIONS: A task force developed and implemented a practice guideline that encouraged the following: 1) signing of pain contracts; 2) requiring patients to undergo random urine drug testing; and 3) requiring random pill counts. North Carolina implemented a statewide registry in 2007 that contained information on virtually all opioid prescriptions filled by pharmacies. MAIN OUTCOME MEASURE(S): Opioid pill confiscations by the Caldwell County Narcotics Division 24 months prior to implementation of the guidelines, the first 12 months during guideline implementation, and 12 months after the guideline was fully implemented. RESULTS: From 2005 to 2007, opioid pill confiscations decreased by 300 percent. Of the 35 physicians who were sent surveys, 27 responded (77 percent response rate). Ninety percent of respondents who prescribe opioids use the chronic pain guidelines. Sixty percent report an improvement in the overall management of patients with chronic pain; 65 percent reported having more confidence in treating patients with chronic pain; and 60 percent reported using the opioid registry. CONCLUSIONS: This county wide medical initiative appears to have resulted in a significant improvement in the abuse and diversion of medically derived opioids.
PP - United States
PY - 2012
SN - 1551-7489; 1551-7489
SP - 363
EP - 367
EP - 
T1 - Improving use of narcotics for nonmalignant chronic pain: a lesson from Community Care of North Carolina
T2 - Journal of opioid management
TI - Improving use of narcotics for nonmalignant chronic pain: a lesson from Community Care of North Carolina
U1 - Opioids & Substance Use; Healthcare Disparities
U2 - 23264314
U3 - 10.5055/jom.2012.0136
VL - 8
VO - 1551-7489; 1551-7489
Y1 - 2012
ER -