MLTCN Res Care, January 2019, Christopher Laxton

An influential group representing doctors in long-term care has urged nursing homes, when possible, to avoid prescribing opioids to residents.

The Society for Post-Acute and Long-Term Care, or AMDA, issued a new policy statement on the use of painkillers in skilled care in December. It said that providers should prescribe opioids when the drugs can help to relieve suffering and improve or maintain functions. However, when those goals are not achievable, nursing homes should discontinue their use, taper patients off of them, and avoid them in the future.

AMDA also advocated for more uniformity in how states regulate opioid use.

“Our public policy priorities regarding opioid use are to reduce the variability in state laws and regulations regarding opioid prescribing, while acknowledging the unique needs of the PALTC patient population,” said Executive Director Christopher Laxton.

The policy includes four principles nursing home  medical directors can adopt: (1) conducting an interprofessional assessment of the resident receiving painkillers (2) minimizing the risk of adverse events, dependency and diversion (3) guiding prescribers with education and safety training and (4) adopting policies that promote access to substance use disorder specialists and reduce barriers to obtaining medications that can treat dependence.