IHI 2016: 4 main drivers to reduce opioid use in the U.S.

A coctor writing a prescription
The healthcare industry must work with communities to address the opioid crisis in America. Photo Credit: Getty/18percentgrey

ORLANDO, Fla.–Efforts to curb the opioid epidemic in the United States will require a systemwide design that brings the entire community together to address all the factors that impact addiction, including healthcare, a patient’s home life and the criminal justice department. 

That’s the goal of two members of the Institute for Healthcare Improvements Innovation team, who have spent the past year conducting research to find a community that has had success with a systems approach. They did not find it, according to Lindsay Martin, executive director and improvement advisor at IHI and Mara Laderman, senior research associate.

Although some communities and healthcare providers have made strides with innovative ideas, such as having police detectives serve as case managers, these individual efforts aren’t enough to make a significant dent in the crisis, Martin and Laderman told news reporters during a press briefing Monday at IHI’s 28th annual National Forum on Quality Improvement in Healthcare. Although there is a lot of good work at the individual level, Laderman said communication and coordination within the entire community is missing.

Lindsay Martin

“Without addressing the system as a whole, it will have limited impact,” Martin said.

For example, in Massachusetts, addicts have access to opioids via healthcare systems and illegally, but they also can drive an hour to three or four different states and get painkillers at health systems not linked to the Massachusetts’ prescription monitoring system.  

Some of the largest growing groups of opioid addicts are middle-aged women and high school students involved in youth sports, they said. When teenagers suffer an injury on the field, they are often given prescription painkillers and quickly become addicted to them, and struggle with the addiction throughout their lives.

Although it may take years to get a handle on the epidemic, Martin said there is now an opportunity for healthcare providers to work together with their communities and share successes and failures.

Mara Laderman

Based on their research, Martin and Laderman believe an effective system-approach model to combat the crisis will encompass four drivers:

  • Limit supply of prescription opioids and heroin.
  • Raise awareness of the risk of opioid addiction. This is a two-pronged approach. It will require the healthcare system to change prescribing and expectations, as well as resources outside of healthcare to prevent adults and youth from recreational use. Furthermore, the community must reduce the stigma of addiction to help encourage addicts to seek treatment
  • Identify and manage the opioid-dependent population. This driver needs to focus on the healthcare system, which must compassionately treat and wean chronic opioid use
  • Treat opioid-addicted individuals. This will require the engagement of stakeholders throughout the entire community (i.e., a collaborative, community-wide approach).