What’s Up, Doc?
Intermountain Healthcare Has Prescription for Opioid Epidemic
Utah may not get as much news coverage as other areas of the United States, but in the last several years it has found itself in the middle of the same devastating opioid epidemic plaguing the rest of the country.
The stats are grim — Utah currently ranks seventh nationwide for opioid overdose deaths, and drug poisoning surpasses the death toll caused by firearms, falls and car accidents combined. What’s more, prescription rates are through the roof: Enough opioids are prescribed that 89 out of 100 of the state’s adults could receive a prescription annually. The crisis is expensive, too, costing Utah about $237 million in health care costs annually. But the numbers are only half the story. The emotional costs are astronomical as people lose lives, livelihoods and loved ones to the tragedy.
Intermountain Healthcare Leading the Charge
In the face of such dire circumstances, it would be easy to wring hands. Instead, members of Utah’s medical community are rolling up their sleeves, working collectively to make the opioid crisis a thing of the past. Leading the charge is Intermountain Healthcare, one of Utah’s most prestigious and far-reaching medical institutions, and its goal is nothing if not lofty: In its own practice, the aim is to reduce the number of opioid prescriptions for acute conditions by 40 percent, educating both doctors and patients about best practices and alternatives. But the health care organization is not stopping there.
“We really wanted to move outside the walls of the hospital,” says Lisa Nichols, Intermountain’s community health partnership director. “We wanted to collaborate with our partners and do something preventive in nature.” So in 2015, Intermountain brought together a variety of nonprofit and public organizations to form the Opioid Community Collaborative, a coalition that works to stamp out opioid misuse, overdose and death. Instead of addressing the opioid epidemic in a narrow, ad hoc manner, the collaborative is taking what Nichols calls “a multipronged, multisectored approach,” tackling the problem through public awareness, provider education, increased access to care and policy change.
Educating the Public
To educate the public, the collaborative has released public service announcements, put up billboards, and even launched a weekly radio show. “We talk about a multipronged approach with lots of partnerships, and consumers have to be one of those partners,” Nichols says. As such, patients are encouraged to talk with their doctors about prescription options, as well as alternative treatments. And the effort is working: In 2017, 83 percent of individuals included in a random survey reported talking to their doctor about the risks of opioid prescriptions, and 53 percent asked about alternatives.
Acknowledging that health care providers have contributed to the problem as well, Nichols says, “We’re working with our prescribers to prescribe less, to understand the dangers, and to have conversations with their patients about alternatives.”
Drop Boxes and Naloxone Kits
Other efforts by the collaborative include funding community drop boxes for medication to encourage people to get it off their shelves. In just two years, the drop boxes have aided safe disposal of 15,000 pounds of pills.
The collaborative has formed a speakers’ bureau that educates people and provides access to the overdose-reversing drug, Naloxone. It has launched a six-week, science-based course to teach people alternative ways to manage chronic pain and has funded two community mental health partners to provide medication-assisted treatment to people who need care. So far, the collaborative has funded 2,400 Naloxone kits, offered 10 pain management classes to 110 people, and helped 306 people access treatment — a program that maintains an 85 percent abstinence rate.
Shifting Public Perception of Pain
Thanks to efforts of the collaborative and other community groups, the state saw a 10 percent decrease in opioid overdose deaths in 2016. That’s good news on an issue where good news is hard to come by.
The collaborative, however, is just getting started. The goal is another 10 percent decrease in deaths next year, and — more broadly — a shift in public perceptions of pain.
“We’ve become a culture that thinks that we should avoid pain at all costs,” Nichols says. “What we’d like to see is an awareness that you’re going to have some discomfort sometimes, but it will pass and be okay. We want to ensure that pain medications are available when necessary but also recognize that they are not always necessary or helpful.”