One of this year’s new In the Rheum sessions will encourage attendees to think about designing novel questions that can lead to answers in stemming the ongoing opioid epidemic.
In the Rhuem: Pain Management During an Opioid Crisis features Anupam B. Jena, MD, PhD, the Ruth L. Newhouse Associate Professor of Health Care Policy at Harvard Medical School and a physician in the Department of Medicine at Massachusetts General Hospital. The session will take place from 2:30 – 3:00 pm in the Sidney Marcus Auditorium, Building A in the Georgia World Congress Center.
In The Rheum sessions have been designed so leading experts can talk about the most important and somewhat controversial topics facing the rheumatology community. These shorter sessions are designed for less formal presentations and more discussion between presenter and audience.
Dr. Jena is also a Faculty Research Fellow at the National Bureau of Economic Research. His general approach toward researching this issue is asking questions related to prescription opioid use that others haven’t considered.
This session will spotlight how attendees’ experiences and insights treating people with chronic pain can help identify questions that can guide research into opioid abuse, Dr. Jena said, since clinicians are already familiar with pain management and treating patients with chronic pain.
“I think the clinicians in the room will have really terrific ideas that could lend themselves to research, but they maybe never have been trained in the process of doing that kind of research,” he said. “Thinking about your job and in a broader way like this — and the kind of questions that it can lead to is very meaningful.”
Dr. Jena said that he hopes attendees also leave the session with an understanding that there is systemic data that illustrates the role of the individual physician in the opioid crisis. He will discuss some of his research, including a look into whether a single prescription could lead to long-term opioid use. Data involving Medicare patients visiting an emergency department (ED) who had not been prescribed an opioid for at least a year show that those who saw a physician with a higher-than-average propensity to prescribe opioids not only were more likely to leave the ED with a prescription for an opioid, they were more likely to become a long-term user.
“That’s relevant because it says that two people who by chance each see a different provider now face a different trajectory both in terms of short-term opioid use and long-term opioid use,” Dr. Jena said. “I think that’s quite direct evidence of the role of the physician in opioid prescribing and also direct evidence of the impact that a single prescription could have.”
Other studies Dr. Jena expects to cover during the session include the amount of variation between hospitals about prescribing opioids upon discharge and the role diversion of opioids within families may play in the epidemic.
Researchers observed that when some long-term prescriptions stopped, within days a family member went to the pharmacy to fill a new prescription.
“It suggests that there is some degree of diversion — not a lot — that might be occurring,” Dr. Jena said. “And it means that when you’re thinking about stopping someone who’s been on long-term opioids, you must do it in a careful, thoughtful way because this is one of the potential byproducts.”