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Pennsylvania’s Response to the Opioid Crisis

Sadly, like many other states, Pennsylvania has experienced an alarming rise in drug overdose deaths, and its overdose death rate is more than twice the national average. In fact, more deaths now occur as a result of overdosing on prescription opioids than from all other drug overdoses combined, including heroin and cocaine. “The Office of the Attorney General arrests on average more than four drug dealers a day," Attorney General Josh Shapiro said in a statement. "Our arrests of medical personnel and others for illegally diverting prescription drugs are up 72 percent. Our national investigation with 41 attorneys general of the pharmaceutical industry and the opioid painkillers fueling this epidemic is ongoing and active." The opioid epidemic is tied closely to another epidemic in our country, that of chronic pain—although the ties are very complex. Opioid prescribing for chronic nonterminal pain has increased in recent years, although evidence for its long-term effectiveness is weak and its potential for harm is significant. The Agency for Healthcare Research and Quality reviewed studies on the effectiveness and risks of long-term opioid treatment of chronic pain. The results are eye-opening: No randomized trials or comparative observational studies meeting the reviewers’ criteria were found that addressed opioids’ effectiveness for chronic pain or comparing their effectiveness to other treatments, making it impossible to know whether long-term treatment with opioids adequately addresses patients’ symptoms or improves their functioning or quality of life. At best there was weak evidence regarding optimal dosing strategies with these medications. According to Governor Wolf’s administration, “proper treatment of chronic pain includes an interdisciplinary and multi-model approach that is tailored to help the patient control pain and relieve suffering.” Specific treatment options should be based on best evidence whenever possible. People who experience chronic pain should know and have discussions with their physicians and family concerning alternatives to opioid therapies. For instance, there are non-opioid medications such as acetaminophen, non-steroidal anti-inflammatory medications, anti-seizure medications, and local anesthetics. In addition, there is growing interest in the use of cannabinoids for the treatment of a variety of chronic pain conditions. Cognitive-behavioral therapy and mindfulness- based therapy can provide improved symptom control, physical functioning, adaptive coping and self-efficacy. Moreover, treatment of comorbid depression and anxiety can improve biopsychosocial functioning. Physical therapy, including aquatic therapy, and massage therapy can be a critical component in improving pain control and physical functioning in most patients. Even supportive modalities such as yoga and Tai Chi may be very effective in improving pain and physical functioning in some patients. Interventional therapy, such as epidural steroid injections, radiofrequency procedures and spinal cord stimulation, can also provide effective pain relief in patients experiencing specific pain disorders. Pennsylvania has established 11 prescribing guidelines for health care providers including:
  • Worker’s Compensation Prescribing Guidelines;
  • Treating Chronic Non-Cancer Pain;
  • Emergency Department Pain Treatment Guidelines;
  • Opioids in Dental Practice;
  • Opioid Dispensing Guidelines;
  • Obstetrics and Gynecology Opioid Prescribing Guidelines;
  • Geriatric Pain;
  • Use of Addiction Treatment Medications in the Treatment of Pregnant Patients with Opioid-Use Disorder;
  • Safe Prescribing Benzodiazepines for Acute Treatment of Anxiety and Insomnia;
  • Safe Prescribing Guidelines for Orthopedics and Sports Medicine; and
  • Safe Prescribing of Opioids in Pediatric and Adolescent Populations.
The following guidelines address the use of opioid pain medication for chronic noncancer pain. They are intended to help healthcare providers improve patient outcomes and to supplement, but not replace, the individual provider’s clinical judgment. 1. Before initiating chronic opioid therapy, clinicians should conduct and document a history that includes a detailed review of the patient's pain experience, including assessment for co-existing: depression, anxiety disorders and sleep disorders; past and current substance use disorder, as well as risk assessment for development of aberrant drug-related behavior following chronic opioid administration. Evaluation should include assessment for conditions that increase the risk of harm from chronic opioid administration, including sleep-disordered breathing, pulmonary disease, and concurrent use of centrally-acting sedating medications. 2. Appropriate testing to confirm the underlying diagnosis should be completed before starting chronic opioid therapy. 3. A urine drug screen should be obtained and reviewed before initiating chronic opioid therapy. In addition, Pennsylvania state law requires clinicians to obtain and review a report from the Prescription Drug Monitoring Program (PDMP) before prescribing all controlled substances. Care should be taken to obtain PDMP data from all relevant states, which usually can be accomplished through the Pennsylvania PDMP program. 4. Medical records from past health care, including the results of relevant laboratory and radiological studies, should be obtained and reviewed, as they often are a valuable source of information regarding past care, including response to medications, specifically opioids. 5. The initial patient evaluation should include documentation of a diagnosis, treatment plan and goals of therapy. Goals of therapy should be specific and measurable, and should be integrated into ongoing patient monitoring throughout treatment. To view the Guidelines for Initiation, Continuation and Discontinuance of Opioid Therapy, click here. While not specifically referenced in above referenced guidelines, health care professionals should consider encouraging patients with chronic pain being managed by opioids to include their family members in their treatment plans, as valuable information can be gleaned from these sources that may improve the treatment plan, and therapeutic outcomes. For more information on the above topics, check out these links: https://www.drugabuse.gov/about-nida/noras-blog/2014/09/opioids-chronic-pain-gap-in-our-knowledgehttp://6abc.com/health/gov-wolf-declares-a-disaster-emergency-over-opioid-crisis/2924563/https://www.pilot.health.pa.gov/topics/Documents/Opioids/Non-cancer%20Pain%20Guidelines%20Final.pdf
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Two kids out trick-or-treating at night

No Boo-Boos! Keeping Everyone Safe This Halloween

It’s October! The scary season! A month of haunts, costumes, and candy, all leading up to the most chillingly fun holiday of the year: Halloween! Whether you’re a parent of kids who will be trick-or-treating or a homeowner handing out treats to the goblins who ring your doorbell, Halloween is a wonderful example of a holiday that’s fun for the adults as well as the kids. We hate to dampen the mood, but you need to be aware that Halloween can be legitimately scary for parents—and not the good kind of scary. Research by the Journal of the American Medical Association found that the risk of pedestrian fatalities is 43 percent greater on Halloween night than any other night of the year. The only things that should be scary this month are the costumes and the haunted houses! That’s why Halloween safety, whether your kids are trick-or-treating in Wheeling, Moundsville, St. Clairsville, or anywhere else in the Ohio Valley and southwest Pennsylvania, is so important. Here are some tips for keeping kids safe on Halloween. Safe Trick-or-Treating Most trick-or-treating occurs during twilight (sunset in Wheeling on Oct. 31 is around 6:20 p.m.) or early darkness. Although it won’t matter as much when Halloween falls on a weekend, rush hour at this time puts more cars on the road. Even when parents are accompanying their kids trick-or-treating, crossing streets and walking along roads that don’t have sidewalks increases the risk of something tragic happening. But that shouldn’t stop your family from trick-or-treating. Here are some things you can do to keep you and your kids safe on Halloween (or whichever day your town is scheduling trick-or-treating): Give flashlights to your kids to carry as they cross streets or walk along roads. Don’t rely on the lights on smartphones to be visible—they aren’t designed to make you visible. Small handheld flashlights can be easily pointed and are more easily seen by drivers. (Plus, if you stand on the sidewalk while your kids go to a door to get candy, you can shine your flashlight in their faces to remind them to say “thank you” if they forget …) Be extra visible by adding reflective strips to your kids’ costumes and giving them glow sticks to wear around their necks or wrists. Cross at crosswalks instead of the middle of the block. It’s tempting for kids to run back and forth across the street to go to a house where they see lights on, but drivers might not be as vigilant for pedestrians away from the corners, especially if kids are darting out behind parked cars. Encourage your kids to take off masks when walking along roads. You don’t want to take away from their great costumes, but masks can limit peripheral vision, which isn’t good when walking next to traffic. They can always put the mask back on when they ring the doorbell to sufficiently impress homeowners! Similarly, be extra aware if your child’s costume restricts any movement, such as a dress on a princess (and every year, there are plenty of princesses!) or a cloak on a Grim Reaper. Even without traffic, tripping over a curb can hurt—and Halloween is not the night you want to go to the emergency room. Remind them to watch their step and not run. Hold your kids’ smartphones so they aren’t tempted to be checking them while walking along roads and crossing streets. This advice extends to parents: Keep your phone in your pocket, only taking it out when you’re away from traffic. Take plenty of pictures—just when it is safe to do so. Older kids might want to trick-or-treat on their own, which is understandable, because what middle schooler wants their parents with them on Halloween? Reinforce all the Halloween safety rules already mentioned, and add a few: Give them a curfew to be back home. The later Halloween gets, say after 8 p.m., the fewer commuters on the roads, replaced by less careful teenagers and college students. Provide a firm curfew, and even offer to let their friends come over and watch a scary movie instead of being on the streets. Hold them to the same Halloween smartphone rules you’re following yourself: Phones should be pocketed when they are near traffic. Tell them it’s OK if they don’t answer your call or text right away—they should do so only when it’s safe. This may seem like a no-brainer (zombie pun intended!), but remind them not to go into the home or backyard of anyone they don’t know. Also, tell them to always stay with their group of friends and don’t split up. Halloween Safety for Drivers and Homeowners Halloween safety is everyone’s responsibility—not just trick-or-treaters and their parents. No one wants kids to get hurt on Halloween, and you don’t want to deal with the consequences if someone is injured by your vehicle or on your property. Here are some tips that can help keep everyone safe on the spookiest night of the year. Driving If you are driving anywhere near trick-or-treaters, slow down, turn your headlights on (even before it gets fully dark), and be extra vigilant on side streets, pulling into driveways, and even at crosswalks. Never assume those kids won’t run into the street, even if they are with their parents. And if you don’t need to drive anyplace during peak trick-or-treating hours, stay home. Your Home You want the front of your home to be as inviting as it can be for trick-or-treaters, but you also want it to be safe. For example, an orange porch light may be wonderfully eerie, but it also can make it more difficult to see as you climb stairs. Go back to a white light for a couple hours, keep your porch clear of obstacles (e.g., pumpkins should be off to the side), and keep any electrical cords off the walkway where someone could trip over them. Also, if you have any mechanical decorations that deliver jump scares, make sure they aren’t scaring anyone standing on your steps. Your Dog Some dogs are mellow when the doorbell rings dozens of times a night, and some will go nuts. Protective or agitated dogs may try sneaking out of the front door and could bite or knock down trick-or-treaters—and you could be liable for injuries. You know your pup best, but err on the side of caution: Consider keeping your dog(s) away from your front door, maybe in another room or in a crate, while you are handing out candy to trick-or-treaters. Or, set up shop outside, on your porch or driveway, so that your doorbell isn’t being constantly rung. ******************************** From all of us at Bordas & Bordas, have a safe and truly boo-tiful Halloween!

What to Do After a Truck Accident in West Virginia, Ohio and Pennsylvania

What to Do After a Truck Accident in West Virginia, Ohio and Pennsylvania A recent trucking accident on I-70 near Wheeling caused serious injuries and brought traffic to a standstill. These kinds of accidents are all too common in West Virginia, Ohio, and Pennsylvania, especially on major highways like I-70 and I-79. If you’re involved in a crash with a commercial truck, knowing what to do next is critical for your health and your legal rights. Protecting Yourself Legally and Medically If you’re involved in a truck accident: Call 911 immediately. Document the scene (photos, notes, witness names). Seek medical attention—even if injuries seem minor. Commercial trucking accidents are far more complicated than regular car crashes. The trucking company, driver, and even cargo loaders may all play a role in what happened. That’s why it’s so important to protect yourself early. Truck crashes often involve federal trucking regulations in addition to local laws. The Federal Motor Carrier Safety Administration (FMCSA) requires drivers to operate with “extreme caution” in hazardous conditions, a regulation often cited in legal cases. Don’t Navigate This Alone Trucking companies have their lawyers working to limit what they pay. Victims need someone in their corner who understands both state and federal laws across the tri-state region. An experienced attorney can help preserve evidence, negotiate with insurers, and ensure you’re treated fairly.  At Bordas & Bordas, we fight to protect victims and ensure they’re not taken advantage of during this complex process. Learn more about truck accident claims

Bordas and Bordas Attorneys celebrating 40 years of justice from 1985 to 2025 with the message "Fighting for Justice for 40 Years.

Fighting for Justice for 40 Years

Fighting for Justice for 40 Years In 2025, Bordas & Bordas is proudly celebrating 40 years, a testament to our unwavering commitment to serving our community and fighting for justice. Since our founding in 1985 by Jim and Linda Bordas, we’ve grown from a small practice into one of the region’s premier personal injury law firms with offices in Pittsburgh, Pennsylvania, Wheeling and Moundsville, West Virginia, and St. Clairsville, Ohio. The story of Bordas & Bordas Attorneys PLLC began with a unique partnership. Linda, a former hospital pharmacist turned lawyer, and Jim, who has been described by many as a giant in the legal profession, combined their expertise and passion for justice to open the doors of Bordas & Bordas upon Linda’s graduation from law school in 1985. Their remarkable record, including never losing a trial together, fueled the firm’s early success. Linda’s medical background proved invaluable, particularly in medical malpractice cases, where she became a leading force, securing landmark verdicts and expanding patient rights. Jim spent his career fighting battles for his clients that others couldn’t or wouldn’t fight. For over four decades, he built a reputation of success through landmark jury verdicts and settlements. In 2000, the Bordas legacy continued with the addition of Jim and Linda’s oldest son, Jamie, who became the firm’s managing partner in 2005. Jim cherished working alongside Jamie, creating a strong bond, and ensuring the firm’s values would endure. Linda remains a partner at Bordas & Bordas and continues to provide guidance and advice as we continue to fight for justice. Our Core Values: The Shield of Bordas & Bordas Our logo, a shield with four quadrants and a central cross, symbolizes what we hold dear: Experience: Four decades of dedicated legal service. Family: A firm built on strong family values and lasting relationships. Community: A commitment to serving and giving back to our community. Results: A proven track record of securing substantial recoveries for our clients. Christian Values: The Cross in the center represents the moral compass that guides our work. Our Commitment to You A lot has changed in 40 years, but one thing remains the same: Our reputation for taking on any opponent in the courtroom. This is backed by years of success and record-breaking results, including numerous multi-million-dollar verdicts and settlements across a wide range of personal injury practice areas. We understand the challenges clients face, which is why our cases are handled on a contingency fee basis. This means clients pay no fee unless we secure a recovery for them. We offer: Free initial consultations. No retainer required. We advance all case expenses. Our work has garnered national attention, with features on programs like 60 Minutes, Inside Edition, and CNN, showcasing our dedication to seeking justice for our clients. Learn more about our results by clicking here. As we celebrate 40 years, we reaffirm our commitment to providing exceptional legal representation and upholding the values that have guided us since 1985. We are grateful for the trust our clients have placed in us and look forward to serving our community for many years to come.