- Healthcare stakeholders are coming together in the fight to overcome opioid abuse, one of the most significant public health crises to hit the nation in recent memory. Claiming dozens of lives each day, opioid abuse often begins with a well-intentioned prescription, and can be fueled by unused medications “borrowed” from friends and family members.
While communities across the country are starting to invest in emergency rescue strategies like naloxone that can save lives after an overdose, Surgeon General Vivek H. Murthy, MD, MBA, has been joined by organizations across the care continuum in urging providers to curb opioid abuse at the source.
“Nearly two decades ago, we were encouraged to be more aggressive about treating pain, often without enough training and support to do so safely. This coincided with heavy marketing of opioids to doctors. Many of us were even taught – incorrectly – that opioids are not addictive when prescribed for legitimate pain.”
The impact of this mistaken belief has been “devastating,” he said, noting that deaths attributed to opioid abuse have quadrupled since 1999.
Despite the fact that Americans do not report considerably more pain than they did in previous years, the number of opioid prescriptions doled out annually has increased significantly over time, reaching 249 million in 2013 and leaving patients with a surplus of medications that create situations ripe for abuse.
Nearly 30,000 people died in 2014 due to overdoses of heroin or prescription opioids, the Surgeon General’s report says, and more than 27 million people reported use of illicit drugs or misuse of prescription drugs in 2015, resulting in an estimated $193 billion economic impact every year.
“I know solving this problem will not be easy,” Murthy continued. “We often struggle to balance reducing our patients’ pain with increasing their risk of opioid addiction. But, as clinicians, we have the unique power to help end this epidemic. As cynical as times may seem, the public still looks to our profession for hope during difficult moments. This is one of those times.”
Murthy encourages providers and other stakeholders to sign the “Turn the Tide” pledge, a joint initiative with the Department of Health and Human Services aimed at changing provider attitudes towards addiction.
Improved provider education, coupled with increased monitoring strategies, may help to reduce the number of unnecessary or excess opioid prescriptions without leaving patients in pain, agrees the American College of Surgeons (ACS).
Using grant funding from Pacira Pharmaceuticals, ACS is launching an initiative to develop education for surgeons and patients about the correct usage of opioids for perioperative pain management.
“The surgical community has a unique opportunity to highlight the impact of the consequences of opioid use and to create resources for use by surgical professionals and patients,” said ACS Division of Education’s Founding Director Ajit K. Sachdeva, MD, FACS, FRCSC.
“There is an increased national awareness of opioid use and addiction and resources have been developed for professional training. However, specific education is not readily available for patients and their families, and new resources are needed for surgical professionals in their care of patients.”
The project will teach providers how to identify high-risk patients and how to employ pain management strategies that are not reliant on opioids. Surgical providers will learn how to more effectively monitor patients for signs of opioid misuse and how to treat and council patients showing signs of addiction.
“This initiative provides us with an innovative opportunity to address a growing patient safety problem in the United States,” added ACS Executive Director David B. Hoyt, MD, FACS.
“The ACS mission is to provide optimal surgical patient care and with grant funding from Pacira, we can now provide additional resources for better management of perioperative pain. This program will build on the success of our diverse catalog of patient education and skills training resources.”
Cigna is also urging providers to reexamine their prescribing habits by creating its own initiative to monitor opioid use and reduce opportunities for addiction. In line with the “Turn the Tide” project, the payer is asking its providers to promise to reduce opioid prescriptions and to treat opioid addiction as a chronic condition.
Participants in the Cigna Collaborative Care program will be asked to participate in enhanced prescription tracking initiatives and quality reporting, and to invest in concrete actions that will result in more judicious use of painkillers.
“Improving the quality of care and delivering better health outcomes for our customers are at the core of Cigna Collaborative Care. Adopting this pledge is an opportunity to shine a light on one of the biggest crises we face in health care today and enables us to work collaboratively with our clinical partners to find effective solutions,” said Dick Salmon, MD, Cigna's vice president and national medical executive for performance measurement and improvement.
Using claims data and analytics, Cigna will alert providers when they veer away from CDC opioid prescribing guidelines and will deliver educational resources to physicians in an effort to help them improve their clinical decision making.
“The resources we share with our provider partners will benefit all of their patients, not just those who are Cigna customers,” Salmon said. “Cigna is committed to reducing the burden of substance use disorders for all Americans.”
“The misuse of opioids is taking a terrible toll on our country. We simply must find solutions, but that’s not something that any one of us can do alone. Through this pledge we invite medical groups to join us and participate actively with us. By working together, we hope to identify specific actions that can break this national epidemic.”