Fighting the opioid epidemic through awareness and education. Opioid abuse is a dangerous worldwide epidemic that continues to grow. AS PART OF the ongoing war against opioid abuse, U.S. Senators Dick Durbin ( D-IL), Sherrod Brown (D-OH), Angus King (I-ME), Amy Klobuchar (D-MN), and. N C Med J. May-Jun;79(3) doi: /ncm Fighting the Opioid Epidemic in North Carolina with Leadership, Compassion, and.
the Epidemic Fighting Opioid
Individual institutions—medical, legal, or other—are usually well positioned to focus on one or more of these specific themes. The two remaining themes are broader in nature; because they support all the other themes, we consider them foundational enablers. Given the extent of the opioid crisis, ensuring that best practices are spread as widely as possible is hugely important. On its own, though, best practices will likely not be sufficient to combat the crisis—fundamental innovation is also required.
Admittedly, there is no purely empirical way to classify a strategy or tactic as a best practice. Nevertheless, our research reveals that consensus is emerging on a collection of strategies for both prevention and treatment. For example, a growing number of states, payers, and health systems are putting greater emphasis on understanding and altering how opioids are prescribed to whom, when, at what dosage, and for how long.
Many stakeholders are also developing more sophisticated clinical guidelines for pain management and opioid prescribing. Blue Cross NC caps opioid prescriptions at 7 days for some. Some health systems and prescribers have been making significant changes to the way they approach pain management and prescribing.
Stemming the opioid tide. With respect to treatment, most states are expanding the use of naloxone to prevent overdose deaths, and consensus is growing that medication-assisted treatment MAT combined with psychosocial assistance is probably the most effective treatment for opioid addiction.
Guidelines for the psychosocially assisted pharmacological treatment of opioid dependence. Both state organizations and private stakeholders are taking concrete steps to encourage greater use of MAT and expand treatment capacity.
Despite growing alignment on the importance of these practices, there is significant variation in the degree to which the practices are being put into place. Some of the variation is geographical: Pearson CF, Soh C. Midwest and mid-Atlantic states face provider shortage to address opioid epidemic.
Medication-assisted opioid treatment prescribers in federally qualified health centers: Capacity lags in rural areas. Journal of Rural Health. Payer and provider organizations differ considerably in how aggressively they are implementing opioid strategies. If we look at prescribing practices, variation among clinicians is enormous; as Exhibit 3 shows, some orthopedic surgeons in one state rarely, if ever, prescribe opioids for common sprains, whereas others in the same state appear to do so routinely.
There is no doubt that more consistent use of best practices—across geographic areas, institutions, and clinicians—would provide tremendous help in combating the crisis. The Centers for Disease Control and Prevention estimates that lack of consistency in prescription guidelines could explain up to two-thirds of the geographical variations at the county level in opioid prescribing.
Guy GP et al. Changes in opioid prescribing in the United States, — Multiple payers and providers have been successful in reducing prescribing through better guideline use. Cigna intensifies effort to curtail opioid epidemic by confronting opioid addiction and overdose in U. Blue Cross Blue Shield Association. Volkow ND et al. Medication-assisted therapies—tackling the opioid-overdose epidemic.
New England Journal of Medicine. However, MAT medications are prescribed in less than half of privately funded opioid treatment programs—and less than one quarter of publicly funded programs.
Knudsen HK et al. Adoption and implementation of medications in addiction treatment programs. Journal of Addiction Medicine.
Hostetter M, Klein S. Reporting on health system improvement. Nevertheless, scaling best practices, on its own, is not likely to be sufficient to combat the crisis. Even the states with the most purposeful, aggressive strategies to address the opioid epidemic are experiencing continued abuse and addiction. The most effective prevention efforts have slowed but not reversed the rate of growth. Between and , not a single state had a statistically significant decrease in the overdose death rate.
During that same period, only four states Massachusetts, Kentucky, Tennessee, and Connecticut —each of which is working especially hard to tackle the opioid crisis—managed to slow the rate of growth in drug overdose fatalities. Drug overdose death data. Furthermore, even the most effective treatment approach currently available e. A research guide Third edition.
Last updated January ]. Some studies have shown that relapse rates are even higher for opioid-abuse treatment. For these reasons, we believe fundamental innovation is required in both prevention and treatment—innovation that meaningfully advances our understanding of the path to OUD and improves the tools and interventions at our disposal to change its course Exhibit 4. It did not include the amounts spent on delivering healthcare services to patients; in terms of the opioid crisis, this analysis would include the cost of substance abuse treatment and alternative forms of pain management.
In short, as of , the opioid epidemic has received markedly less investment across the board. Those who aspire to play a leading role in combating the opioid crisis—regardless of whether they are in business, academia, or the government—should consider the steps outlined below. To date, many, if not most, healthcare stakeholders have understood and reacted to the opioid crisis primarily as a societal problem.
This reaction is understandable, given the size and scope of the crisis and the complex interrelationship between addiction and myriad ostensibly non-healthcare factors, such as economics, culture, education, and crime. However, viewing the crisis as purely a societal problem sometimes gives rise to unfortunate sequelae: Only when leaders of healthcare institutions recognize and declare that the opioid crisis is, in fact, also a healthcare priority and a business problem will fighting it become a real institutional priority.
Such a declaration is a prerequisite to making substantive progress for two reasons. First, it increases expectations that healthcare institutions and their leaders will take steps to actively combat the crisis—doing so becomes an obligation. Second, declaring the crisis a business priority opens the door to greater innovation. It increases the likelihood that new approaches to addressing the crisis—new technologies, products, services, models, etc. For investments in these new approaches to occur at any scale, entrepreneurs, venture capital firms, and large private and public institutions must view combating the crisis as a business opportunity.
Healthcare institutions must define a clear strategy for combating the crisis, just as they do for any meaningful business priority. Most of the healthcare institutions we have interacted with, including government agencies and private-sector players, may be overemphasizing the importance of identifying new or distinct activities they can pursue.
Innovation is certainly needed, as we discussed above. Our research suggests, however, that there is still a lot of room to scale existing best practices across all core processes and that doing so could have material impact.
We believe that effective opioid strategies must systematically consider the role that every part of the institution plays and its impact implicit or explicit on opioid prescribing and treatment of OUD. Government agencies, for example, should consider examining their core regulations, policies, and guidelines, as well as their oversight of key partners and vendors e. Payers should examine their medical policies, utilization management protocols, formularies, provider incentive programs, and network management and configuration.
Health systems should examine their clinical guidelines and protocols, clinician incentives, capital expenditures, physician alignment, and care coordination programs. Pharmaceutical companies should invest in alternative pain management solutions, innovations in OUD treatment, and overdose reversal drugs.
Data and advanced analytics—and technology in all forms—can be powerful tools that can help support all eight of the prevention and treatment themes discussed above.
For example, data and advanced analytics have the potential to identify at-risk individuals and provide insights into the factors that put them at increased risk. In addition, they can help prioritize scarce resources, optimize interventions, compare the efficacy of different approaches, and improve the efficacy of each intervention. We have identified over 50 potential use cases for data and advanced analytics, a few of which are illustrated in Exhibit 6.
Specifically in Cook County, the biggest increase has been in fentanyl-related deaths. According to the Cook County Medical Examiner, there were 20 fentanyl-related deaths in In , there were approximately According to the National Institute on Drug Abuse, the number of opioid prescriptions in the United States has risen dramatically from approximately 76 million in to more than million in Between and , the rate of heroin related overdose deaths nearly quadrupled, with more than 8, people dying from heroin in New and Innovative Programs The letters were part of a multi-pronged approach by numerous groups to combat the growing threat.
Contact Dan Gillen at Dan. Wichern also cites the Robert Crown Center for Health Education in Hinsdale as having an excellent heroin prevention program to help keep children from even trying their first dose. When it comes to enforcement, clearly the DEA is targeting drug gangs and cartels.
Treatment, too, is an area that concerned citizens are targeting. Numerous groups including physicians, law enforcement and politicians are joining forces to increase the availability of Naloxone.
By late , more than Walgreens locations had begun selling the drug with sales at CVS and Jewel-Osco locations quickly following. Wichern also notes that innovative new programs are constantly being introduced.
Missouri House passes bill for opioid prescription tracking
The opioid epidemic has received a lot of attention recently, but how can technology help in the battle to alleviate abuse? There's a digital pill in trials to. There are simple actions you can take in your home to combat the opioid crisis. Two-thirds of teens report getting prescription drugs from family or friends. Opioid overdoses caused more than deaths in , more than any previous year In HHS declared a public health emergency to combat the crisis.