Recently, a report from the White House Council of Economic Advisers found that the opioid crisis cost a whopping $504 billion in 2015, and more than 33,000 Americans suffered opioid-related deaths. While many perceive the opioid crisis to stem from the use of street-acquired drugs, much of this problem originates in the health system—and hospitals are looking for ways to stop the spread of the epidemic.
Sending the Patient Home Safely
Dr. Marc Harrison, President and CEO of Intermountain Healthcare, provided commentary to Modern Healthcare, showcasing efforts made by his system to reduce the number of opioids prescribed. He explains that many patients are sent home post-operation with excessive doses of pain medications that exceed what is needed for the recovery period. When extra pills are around the house, they create an opportunity for misuse, either by the patient or another person living in the home.
“Unused medications become a risk for harmful or unhealthy use. Some studies have shown that two-thirds of all opioids misused and abused come from family members or friends—80% of heroin users began by using prescription opioids,” Dr. Harrison wrote.
Intermountain made a goal for itself to reduce the amount of prescribed opioids by 40%, which would total five million pills per year. To support this, the system offers training to its caregivers, with plans to offer guidance to prescribers in nearby communities as well.
Many hospitals are making similar changes. St. Mary’s Hospital, part of the Bon Secours Health System, has also launched an initiative to cut down on opioids prescribed post-operation. Changes include allowing patients to stay hydrated closer to the time of surgery, and encouraging the consumption of more carbohydrates prior to operation. Using a sample of 100 patients, St. Mary’s saw an 80% drop in post-surgery opioid use as a result of these changes. Some patients could even be discharged sooner than usual as a result.
Opioid Abuse Inside the Hospital
Patient misuse of opioids is not the only troubling component of the opioid crisis. Drug diversion by hospital workers is also a growing concern. A recent ECRI report found that 28% of opioid-related harm in the health system could be tied to prescription theft committed by employees. Such behavior not only harms the employee, but also has a trickle-down effect, as patients may not receive their prescriptions, drugs can be contaminated, and deaths can occur.
Many facilities are employing analytics to provide easier and faster detection of suspicious drug administration patterns that work to identify “diverters” before employees or patients are harmed. These programs allow an organization to take appropriate action and prevent the continuance of thefts.
Such analytics tools can sift through data, and provide actionable insights into drug dispensing activity within a health system. The platform also allows facilities to remain compliant with regulations set by the Joint Commission and Drug Enforcement Administration. Some hospitals still search through records manually to detect suspicious activity—which can be cumbersome and may not provide information in real time, making it more difficult to stop potential harm in its tracks.
Calls for action seem to be having an effect on the impact of the opioid crisis and we hope to see this trend continue in years to come. While public awareness is at an all-time high, this issue is so intertwined in many communities that it may take years to fully repair those areas that have been hit the hardest by these addictions. Hospitals and prescribers must work together to create change, and those that are most adaptable and willing to utilize technology will be on the forefront of solving the problem.