Opioid Safety, Respiratory Compromise

Opioids and Preventing “Dead-In-Bed” Articles PPAHS have been reading the week of May 7, 2018

Articles we have been reading this past week of May 7, 2018 focus on opioids and preventing “dead-in-bed.”

How Often Does “Dead-In-Bed” Happen in Hospitals?

Dead-in-Bed

Dead-in-Bed

We asked this question when we read about this family in Kansas, whose mother was found “dead-in-bed” recovering from surgery:

“Patients on pain killers, often recovering from surgery, quietly suffer respiratory failure while asleep …

“Sheree Thein’s mom, Jadeen Rivard, was hospitalized in 2014 with a partial intestinal blockage. She had her stomach pumped and after a few days she was feeling better. ‘There was nothing going on with her that gave us any reason for concern,’ Thein said.

“Her mom didn’t survive the night.

“Thein said her mother was a victim of what’s called “Dead in Bed,” a phenomenon that’s well-known within the medical community, but not discussed much with the general public.”

Dr. Frank Overdyk, who is an anesthesiologist the Roper St. Francis Health System in Charleston, SC and on PPAHS’s advisory board, estimates that 3,000 to 5,000 Americans die that way every year.

What Should Your Hospital Be Doing to Reduce Opioid Prescriptions?

A study at the Department of Veterans Affairs hospitals and clinics across the country may indicate what hospitals should be doing to reduce opioid prescriptions:

Hospitals that offered more access to alternative pain treatments, such as physical therapy, yoga or acupuncture, also had lower rates of starting patients on long-term opioid therapy. Hospitals that did not as consistently offer those services — or hospitals that also prescribed non-opioid medicines at high rates — were more likely to start patients on long-term opioid therapy.

Taking Benzodiazepines and Opioids – a Deadly Combination

In a clinical education podcast that we did with Thomas W. Frederickson MD, FACP, SFHM, MBA, we discussed the dangers of taking benzodiazepines and opioids in combination.

The FDA recently expanded its warnings against using opioids and benzodiazepines concomitantly:

“The FDA expanded its warnings against using opioids and benzodiazepines concomitantly. This action is based on new information on three specific opioids—buprenorphine, buprenorphine-naloxone and methadone, which are typically prescribed for the treatment of opioid use disorder—and the risk for respiratory depression when these drugs are used with benzodiazepines or other central nervous system (CNS) depressants.

“According to the FDA alert, ‘the combined use of these drugs increases the risk of serious side effects; however, the harm caused by untreated opioid addiction usually outweighs these risks. Careful medication management by health care professionals can reduce these risks.'”

Why Are CDC Opioid Guideline Recommendations Not Being Followed?

According to a study from America’s Health Insurance Plans (AHIP):

“Many of the recommendations from the 2016 “CDC Guideline for Prescribing Opioids for Chronic Pain” show room for improvement when it comes to compliance”

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