4 Steps to Successful Opioid Stewardship

May 6, 2024

Older adults are at significant risk for developing opioid use disorder (OUD) because they are more likely to have the kind of conditions, like arthritis, cancer, or recovery from surgery, that opioids are commonly prescribed for.

And once they start taking opioids, they may be at risk for more severe side effects since, as people age, medications may affect them more intensely and leave their systems more slowly. This can mean falls, depression, and anxiety, and even an increased risk of developing dementia.

To ensure effective relief from pain and resident safety, here are 4 steps you can take to get started with successful opioid stewardship and sustain it long term.

 

1. Look at available non-pharmacologic pain management options first. Do a deep dive, and work with the team to identify the best possible options for each resident. Engage the resident (when possible), as well as family and staff, such as CNAs, who know them best.

 

2. Use assessments to identify the best treatment choices. When pharmacologic pain management is necessary, consider starting with NSAIDs or other pain medications. If and when it’s determined that opioids are warranted, start with the lowest effective doses and re-evaluate on a regular basis.

 

3. Create a culture of safe, effective use of opioids. While staffing, resources, and competing priorities may be barriers, an environment that promotes safer use of opioids can minimize risk. Cultural development opportunities can improve facility buy-in for opioid stewardship initiatives as a driver of quality and outcomes.

 

4. Have leadership and champions. Having champions and a consistent commitment from leadership are critical to ensuring safe prescribing and opioid use while also ensuring that residents’ pain is managed effectively.

 

Your Consultant Pharmacist Can Help
Medication reviews can help spot those at risk of developing OUD. They can also recommend alternative treatments that reduce risk while providing adequate pain relief.

 

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