U.S. Navy Deputy Surgeon General, Rear Adm. Terry J. Moulton, signed the Long-Term Opioid Therapy Safety Program instruction, establishing policies and training designed to ensure the safety of long-term opioid therapy patients, March 14.

New and existing long-term opioid therapy patients with a projected course of therapy of 90-days or longer are now required to undergo a psychiatric and substance abuse history screening. The screening includes an assessment of active thoughts of suicide, and risk of opioid abuse. Patients must also establish an informed consent and opioid care agreement with their clinician. The consent provides information on the risks and benefits of therapy.

"Long-term use of opioids can be effective in limited, select cases, but beginning and continuing such therapy should be an informed, careful decision," said Cmdr. Leo Carney, director, Navy Primary Care and Mental Health. "Once it's decided long-term opioid therapy is the best option to promote healthy functioning for the patient, the new treatment program requires consistent monitoring to ensure the therapy is still effective with no signs of addiction or misuse."

Additional requirements, including urinalysis, are mandated prior to and throughout therapy to ensure the treatment is still effective and there are no signs of opioid abuse.

Navy Medicine is taking several steps to limit opioid prescriptions by educating patients and clinicians on alternative pain management methods. These methods include alternative pain medications, physical therapy, lifestyle changes, chiropractic massage therapy, acupuncture and sometimes surgery. The goal, said Cmdr. Ian Fowler, Navy Medicine Pain Specialty Leader, is to use non-pharmacological approaches to mitigate the risks of opioid use for patients with chronic pain by balancing self-care, primary care, specialty care, integrative therapies and medication.

"Abuse and addiction can happen, and we are tackling this issue head-on in a thoughtful and methodical way, as these medications can greatly decrease pain and improve quality of life." said Moulton. "At the same time, we have a duty to ensure we are using them in a way that minimizes abuse and addiction."

More information about the Long-Term Opioid Therapy Safety Program can be found at: http://www.med.navy.mil/directives/ExternalDirectives/6320.101.pdf.

Navy Medicine is a global health care network of 63,000 personnel which provides health care support to the U.S. Navy, Marine Corps, their families, and veterans in high operational-tempo environments, at expeditionary medical facilities, medical treatment facilities, hospitals, clinics, hospital ships, and research units around the world.

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