Opioid crisis: All hands on deck in hospitals

Opioid abuse has reached crisis levels in the United States, with hospitals and healthcare providers on the frontlines, to the point that President Barack Obama's final budget proposal allocated an additional $559 million to combat it. Now hospital leaders are putting their minds and organizations to work finding solutions to the epidemic.

With an estimated average of 44 deaths per day from opioid abuse, the problem no longer conforms to historical demographics or geographical settings, according to Hospitals & Health Networks. Now providers must work quickly to develop guidance and best practices for stemming the epidemic. For example, the Massachusetts Hospital Association (MHA) established a task force to address opioid management in emergency departments, with protocols for replacing lost or stolen opioids as well as counseling ED patients on medication disposal and storage. All of the MHA's 51 member EDs are on board with the plan, according to the article, and some have made enough progress to move on to the second stage, applying the best practices organization-wide.

Hospitals should also take a cue from Maryland providers' response to an uptick in substance-abuse-related ED visits between 2013 and 2014, Carmela Coyle writes in Hospital Impact. The Maryland Hospital Association and the Maryland Chapter of the American College of Emergency Physicians responded to the increase by developing a series of guidelines, including screening for conditions that increase the likelihood of abuse, standardized prescription protocols to avoid overprescription and using existing data and programs to track any potential abuse.

Despite progress made by hospitals, a few key factors hinder meaningful solutions, Peter Holden, president and CEO of Beth Israel Deaconess Medical Center–Plymouth, told H&HN. For example, he said, acute care hospitals such as Plymouth often don't have the physical capacity to meet the demands created by the crisis. A full-quarter of ED patients at Plymouth have a comorbid behavioral health condition, Holden said, and there's also social stigma to address. "Part of the problem here is that addicts have been treated as criminals, and they're not. They're patients," he told the publication. "These people are sick and they need help, and so we treat them very compassionately and we try to help them get better."

Meanwhile, the Centers for Disease Control and Prevention (CDC) announced it will draft its own guidelines for opioid prescription amid the crisis. The guidelines will break down how to prescribe opioids for chronic pain in a manner that reduces risk of abuse or overuse. The CDC plans to address when it is appropriate to prescribe opioids, how much to prescribe, assessment of risk factors for opioid-related patient harms and duration of treatment, according to the fact sheet. The most-abused opioids include hydrocodone, oxycodone, methadone and oxymorphone.

To learn more:
- read the H&HN article
- here's the interview
- read the CDC fact sheet
- check out the opioid list