Michigan Pain Consultants, a large pain management group with multiple practices in West Michigan, has filed for bankruptcy and will be closing in August 2024. See below for a message from our partners at the Michigan Overdose Prevention Engagement Network (OPEN) and join their team on August 22 from 12:00 p.m. – 1:00 p.m. for more information about managing pain during clinic closures (learn more about the webinar and register).
This closure will increase demand for complex pain management services from primary care clinicians in the region. The Overdose Prevention Engagement Network (OPEN), with support from the Michigan Center for Clinical Systems Improvement (MI-CCSI), would like to share practice tips and resources to support you in responding to this challenging situation and enable safe transitions in care for affected patients.
- Do not abruptly taper or discontinue chronic opioids.
- Abrupt tapers or discontinuation can trigger withdrawal and be unsafe for patients. Because of the unpleasant effects of withdrawal, patients may turn to using illicit opioids, which are often contaminated with fentanyl.
- Do not abruptly taper or discontinue benzodiazepines.
- While benzodiazepine use with opioids increases the risk of overdose, acute discontinuation of benzodiazepines is dangerous and can increase morbidity and mortality. Tapering of benzodiazepines in patients with long-term use often takes months to years.
- Take appropriate steps to enable safe transitions in pain care.
- When establishing care, ensure patients have stable access to their existing opioid prescription medication and then work together with the patient to create a long-term plan.
- It may be appropriate to maintain the patient’s current dosing until a therapeutic relationship is established, which can take weeks or months.
- Verify current opioid medication and dosage using the Prescription Drug Monitoring Database (PDMP) and any available medical records or pill bottles.
- Ensure patients are maximizing use of non-opioid alternatives.
- Offer naloxone to all patients who are prescribed opioids, particularly patients who are at an increased risk for opioid overdose.
- Consider universally screening patients for risky substance use using a standardized screening tool and treat opioid use disorder following evidence-based practice.
- If you have questions about opioid use disorder or other substance use disorder management, utilize OPEN’s free same-day consultation service for clinicians. Services are available Monday through Friday, 9am-5pm, excluding holidays.
- The Michigan Center for Clinical Systems Improvement (MI-CCSI) also has chronic pain and substance use disorder programs and trainings available on their website for clinicians faced with managing patients impacted by sudden practice disruption who are receiving treatment for opioid use disorder.