Here are my top four takeaways for hospitals to prevent, identify, and treat opioid misuse or abuse.
1. Public service organizations, such as fire departments, can play a pivotal role in directing patients in need to treatment centers rather than to the judicial system.
Several New Hampshire counties have "Safe Stations" where people in active addiction can present themselves without any legal consequences. Firefighters ensure the patient is safe and facilitate the transfer to non-profit organizations that specialize in treatment and long-term recovery.
Hospital role: Look for opportunities to partner with public service organizations to reach patients in the community.
Community Hospital of Monterey Peninsula in Monterey, California, started the Monterey County Prescribe Safe Initiative, comprised of 17 organizations throughout the community, including hospitals, advocacy groups, and law enforcement. The group's goal is to implement opioid mitigation efforts such as developing county-wide opioid prescription protocols, initiating community education efforts, and creating safe medication disposal sites.
2. Communities can contribute to prevention efforts through education campaigns aimed at engaging patients in opioid stewardship.
When a patient is aware of the harm associated with prescription opioids, they can proactively play a more vocal role in their treatment plan and ask for alternate treatment options.
Hospital role: Increase patient education on proper use guidelines and potential risks associated with prescription opioids.
Through their work in the Opioid Community Collaborative, Intermountain Healthcare in Salt Lake City, Utah, created public awareness messaging around safe use, storage, and disposal of prescription opioids. The goal was to not only improve medication adherence, but also to increase awareness of the risks associated with prescription opioids.
3. Additional funding to support increased medication-assisted therapy (MAT) treatments, Naloxone prevalence, and prescription drug monitoring program (PDMP) access is essential to impact the current opioid crisis.
Insurance companies play a key role in combating this crisis by covering more MAT treatments, such as buprenorphine. The federal government can inflect change by allocating money to increase access to Naloxone (the opioid-overdose antidote) and by distributing the medication throughout the community.
Hospital role: Partner with community organizations to increase access to Naloxone and enhance prescriber access to PDMPs.
In Stillwater, Minnesota, Lakeview Hospital's EMS staff provide Naloxone to licensed deputies in the Washington County Sheriff's Office. EMS staff also train the deputies on proper Naloxone administration in the case of an opioid overdose. That way, the deputies are prepared to help the patient if EMS staff are unable to arrive in time.
Hospitals should also integrate the state's PDMP into the EHR whenever possible. The direct integration allows prescribers to seamlessly access information about patient's prescription drug history to make informed prescribing decisions.
4. Currently available data does not support full physician accountability for their opioid prescribing patterns.
Physicians are often unaware when one of their patients becomes addicted, overdoses, or dies after taking prescription opioids. Data needs to be disseminated to physicians to "close the loop on death" and ensure they are fully informed before prescribing opioids.
Hospital role: Monitor patient medication adherence post-discharge and during follow-up visits.
To the extent possible, prescribers should check in with their patients post-discharge to ensure proper medication adherence, whether through virtual means (e.g., a post-discharge follow-up phone call) or through in-person visits. During in-person follow-up visits, prescribers should be equipped to identify signs of misuse or abuse and to monitor medication adherence through random pill counts or drug urine screenings.
Your top resources for combating the opioid epidemic
Use this list of helpful resources on how hospitals and health systems can play a role to treat opioid addiction and prevent further increase in opioid abuse.