Curbing an Epidemic: How Providers Impact Opioid Use
Opioid addiction was recently declared a national emergency after New Jersey Gov. Chris Christie, who leads the President’s Commission on Combating Drug Addiction and the Opioid Crisis, likened the death toll to a “Sept. 11 every 3 weeks.”
In 2015 alone, more than 52,000 Americans died of a drug overdose last year, including opioids, and that number is expected to break 60,000 in 2016—more than gun homicides and car accidents combined.
According to the Drug Enforcement Administration (DEA), new strains of heroin laced with the potent synthetic drug fentanyl have become more common, potentially playing a role in the lethality of the street drug. It is estimated that more than 2.6 million Americans are addicted to opioids.
Though there have been efforts to curb this addiction epidemic since the late 2000s, managing such a widespread issue has proven challenging. Even with federal agencies cracking down on “pill mills,” clinics known for dispensing prescription opioids at dangerously high rates, patients are still being prescribed opioids for pain. In the event that patients are cut off from their legal supply, many turn to heroin, fentanyl, and carfentanil.
Top 10 Hospitals Reporting Continuous Opioid Dependence in 2015
|Hospital||State||Est Total # Diagnoses|
|Adcare Hospital of Worcester||MA||3,870|
|Enloe Medical Center||CA||3,567|
|St Lukes University Hospital Bethlehem||PA||3,533|
|PeaceHealth Sacred Heart Medical Center at RiverBend||OR||3,212|
|Florida Hospital Orlando||FL||2,802|
|New Hanover Regional Medical Center||NC||2,800|
|PeaceHealth Southwest Medical Center||WA||2,721|
|Abbott Northwestern Medical Center||MN||2,400|
|St Alphonsus Regional Medical Center||ID||2,293|
|Providence Portland Medical Center||OR||2,289|
Fig 1 Data from Definitive Healthcare
Six states have already taken steps to control opioid overdose rates without waiting for federal action. Maryland, Massachusetts, Alaska, Arizona, Virginia, and Florida have all declared forms of public health emergencies in order to reduce systematic barriers and offer addicts the treatment they need.
Governors in Arizona, Florida, Maryland, and Virginia have declared statewide emergencies.
Definitive Healthcare recently tracked news regarding a partnership between care providers and law enforcement in South Bend, IN, a town on the border of Indiana and Michigan, to fight the over-prescription of opioids for pain management. The organizations involved are Memorial Hospital of South Bend, Mishawaka Medical Center, The South Bend Clinic, and the Allied Physicians of Michiana. This new program will focus on educating healthcare providers on appropriate prescribing practices, which aim to keep both patients and providers safe.
Additionally, Definitive Healthcare tracked news that the Montefiore Health System (New York) and the Einstein Healthcare Network (Pennsylvania) received a joint grant for $3.8 million. The grant will fund a five-year study testing whether medical marijuana can reduce prescription opioid use among patients with chronic pain. The study will focus on people with HIV in particular, as they tend to experience chronic pain at higher rates than the general population.
Now that the opioid crisis has been declared a national emergency, Trump’s administration should be able to remove institutional roadblocks limiting the ways in which states can respond to the epidemic, such as where Medicaid recipients can receive treatment. The DEA may also be able to require prescriber education for doctors and providers who dispense prescription opioids.
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