The facts surrounding the extent of the U.S. opioid epidemic are almost incomprehensible, but here are a few, courtesy of a Frontline report published earlier this year:
Front and center in the story are the nation’s hospitals and health care organizations. It is here that many received their initial prescriptions for opioid pain relievers before they or their loved ones became hooked. It is here that many are taken for treatment upon experiencing the ill effects of abuse. It is here than many are pronounced dead after overdosing on the opioids or heroin their body so craved.
No doubt sickened by what they are witnessing, hospitals are fighting back. Peer support counselors, for example, are popping up in emergency departments in several states to help patients who have survived overdoses kick their addiction. A recent article in Kaiser Health News on such “peer recovery coaches” explained there’s little evidence to back their use. On the other hand, there’s little evidence against it, and anecdotal support is strong.
“Anything I needed, [my peer recovery specialist] was always there,” said a 29-year-old father of three, who in April overdosed for the fourth time in a year. When he spoke with the Kaiser Health News reporter, he announced he was 100 days clean — and credited his success to the around-the-clock help provided by his peer recovery coach.
“That program saved my life,” he said
But it’s not the only one targeting this cruel epidemic. Here’s a look at what some hospitals and health systems are doing.
To help medical teams across the state treat surgical patients’ pain without setting them up for opioid use, misuse, and addiction, the University of Michigan Health System and the Michigan Department of Health and Human Services are in the process of launching the Michigan Opioid Prescribing Engagement Network (Michigan-OPEN)
"Surgeons prescribe nearly 40 percent of opioid painkillers in Michigan, but have few resources to guide them on best use of the drugs by patients before and after surgery," explained Chad Brummett, MD, a Michigan-OPEN's leader and director of the pain research division in the anesthesiology department. "We hope that by working with surgical teams across the state, we can fill that gap for the benefit of individual patients and our state as a whole."
Michigan-OPEN will teach on evidence-based best practices for pain control, including the wisest use of opioid pain medications. The group will also promote drug take-back locations and events to get leftover drugs out of homes, where they can put family members at risk.
To provide quicker access to addiction treatment, Boston Medical Center recently launched an opioid urgent care center. The Faster Paths to Treatment Center is located in the medical center’s ambulatory care center and offers both inpatient and outpatient services for detoxification and follow-up.
Patients receive a comprehensive assessment, referrals to addiction treatment, and education about opioid overdoses, as well as a rescue kit that includes naloxone. An addiction nurse, physician, or counselor sees patients who need to be stabilized. After stabilization, patients are enrolled in maintenance programs.
Along similar lines, Frisbie Memorial Hospital, Rochester, NH, is taking part in an Access to Recovery program that provides residents with 24-hour-a-day services to fight opioid misuse. Patients presenting at the hospital emergency department or police station at any time receive specialized addiction help.
"So if somebody presents at the Rochester Police Department at 2 o'clock in the morning, Southeastern New Hampshire Services are going to send us a certified coach to help them through their trouble," said John Marzinzik, president of Frisbie Memorial Hospital, in a WMUR Manchester report. "We are going all out with this. We are not cutting corners."
Access to Recovery’s services will span health support, mental health counseling, nutrition and physical interventions, and education to help people in recovery reenter the work force.
A new behavioral health pathway to identify hospitalized patients going through opioid withdrawal in addition to receiving treatment for other health concerns is scheduled to launch this month at Christiana Care, Wilmington, DE.
“A lot of patients leave the medical floors against medical advice because they started to go through that painful period of withdrawal," said Aliesha Rivera, behavioral health staff development specialist, in a Delaware Public Media report. "It’s very uncomfortable, so they just get panicked and they just leave without getting any treatment.”
A 2-question screening tool will ask hospitalized patients if they use heroin or prescription drugs other than prescribed and, if they do, do they get sick if they go without them.
“These are individuals who very likely would not have been identified otherwise, who don’t come in self identifying but come into the hospital and begin to have opiate withdrawal ,which is often either not addressed or addressed in a suboptimal way, resulting in poor clinical outcomes and poor patient satisfaction,” said Terry Horton, MD, FACP, chief of addiction medicine at Christiana Care, in the report.
“Most of our patients who are heroin dependent are not happy in their heroin dependence… They’re desperate to move onto recovery, they’re just caught in that horrible cycle of addiction and withdrawal.”
Dr. Horton estimated the pathway will identify 500 patients a year who need help for opioid addiction.
For more information on how your facility can implement safer practice with opioid medications, click HERE to preview our ‘Opioids in the Hospital: Safe Use’ online course from the Lippincott Professional Development Collection library, which is accredited for 1 hr of CE credit.