Anywhere opioids are present there may be a risk of opioid overdose.1-4 That’s why it’s important to have a conversation with your patients. In 2017, there were 47,600 deaths due to opioids.3 Additionally, most life-threatening opioid overdoses occur in the home, likely witnessed by friends or family.3,5
Make this 2-minute talk a key part of your protocol
In just a few minutes you can have an important discussion with your patients about risk factors associated with opioids and what they can do to be ready if an opioid overdose occurs. It may be a difficult conversation to have, but it can make all the difference.
Best practices to consider for having a 2-minute conversation with your patients
I want to take time today to chat about your opioid prescription. I prescribe you opioids because I know they are helping with your chronic pain. I also recognize that you have not had any issues taking them, which is great.
However, with opioids you can never rule out risk. That’s why it’s important that we always pay close attention to your health and safety.
Initiate the discussion
- Provide your patient and their care partner with educational materials
- Encourage your patient to always bring their care partner to appointments
We want to help you and those around you manage the risks. In addition to ensuring you take your opioid medication exactly as prescribed, I strongly suggest that you fill a prescription for take-home naloxone. Opioid medication may cause life-threatening opioid-related respiratory depression, which in essence means you are overdosing. Naloxone is used to counter the effects of opioid medication if there is slowed or stopped breathing.
That’s also why it’s so important that you keep it in an easily accessible place. Think of naloxone like the fire extinguisher you have in your house—there just in case you need it. Opioid-related respiratory depression can occur even if you take your medication exactly as prescribed.
Introduce take-home naloxone
- Provide different ways to think about naloxone, like wearing a seatbelt, having a fire extinguisher or an insurance policy
Although there are different take-home naloxone options available, I prescribe EVZIO. EVZIO is designed to be easy to use. It has voice and visual guidance to help non-medically trained people administer naloxone during an opioid overdose. EVZIO is not a substitute for emergency medical care. It’s important to seek emergency medical attention after use.
Here is a Trainer for EVZIO. I want you to spend a couple of moments using it so you can see how it works and then we can discuss any questions you have. And remember to tell those around you that you have EVZIO and where you keep it, so they too can get to it quickly if needed.
EVZIO is an important part of my treatment protocol. We will ask you about your EVZIO prescription at every visit to ensure your prescription was filled and that you have it on hand.
Educate on EVZIO and the Trainer
- Office staff should show patients how to use the Trainer for EVZIO, and provide them with educational materials
- Document the conversation and make a note to discuss EVZIO with them at every appointment, and check to make sure their prescription is not expired
Help your patients be EVZIO-Ready
Seek emergency medical assistance immediately after use. The use of EVZIO may result in symptoms of acute opioid withdrawal.
- EVZIO [prescribing information]. Richmond, VA: kaleo, Inc.; 2016.
- Substance Abuse and Mental Health Services Administration. SAMHSA Opioid Overdose Prevention Toolkit. HHS Publication No. (SMA) 16-4742. Rockville, MD: Substance Abuse and Mental Health Services Administration, 2018.
- Centers for Disease Control and Prevention. CDC Wonder: About multiple causes of death, 1999-2017. http://wonder.cdc.gov/mcd-icd10.html. Accessed January 28, 2019.
- Federation of State Medical Boards. Guidelines for the chronic use of opioid analgesics. April 2017. https://www.fsmb.org/globalassets/advocacy/policies/opioid_guidelines_as_adopted_april-2017_final.pdf. Accessed January 25, 2019.
- Adams JM. Increasing naloxone awareness and use: The role of health care practitioners. JAMA. 2018;319(20):2073-2074.