The opioid epidemic exploded in 2020 because of the COVID-19 pandemic, which induced isolation and unemployment because of the financial downturn.
In 2020, there have been over 92,000 opioid overdose deaths within the U.S. in comparison with 71,000 in 2019, based on Jerry Storm, senior vp of Pharmacy Providers for OSF HealthCare.
However even earlier than the pandemic and people startling statistics, OSF HealthCare was making strides to assist tackle the opioid disaster by decreasing the quantity of opioids prescribed and getting therapy methods in place.
What’s OSF HealthCare doing?
“We’re frequently educating suppliers concerning the risks of opioids and the way it’s necessary to not use opioids as the first drug to alleviate gentle to reasonable ache,” Jerry mentioned. “When opioids should be used, our steerage is to attempt to restrict the use for under 48-72 hours for extreme acute ache after which transition to a non-opioid ache reliever.”
To realize this, OSF aligned the default variety of tablets or capsules prescribed inside its digital medical file (EMR) system to the Illinois Surgical High quality Enchancment Collaborative suggestions based mostly on process.
“This enables our suppliers to appropriately prescribe portions to match the kind of process being carried out,” Jerry mentioned.
OSF has taken different steps as properly by establishing non-opioid prescription orders within the EMR as an alternative choice to opioids for therapy of gentle to reasonable ache. For these sufferers the place opioids have for use to deal with power ache, a ache contract is established that particulars expectations of the affected person and the implications if the affected person breaks the contract.
“We’ve seen encouraging ends in the variety of opioid tablets allowed per prescription (down 6%), the general variety of opioid prescriptions (down 13%) and within the complete variety of opioid tablets prescribed (down 26%),” Jerry mentioned.
Pointers to comply with
OSF follows opioid prescription for power ache administration tips developed by the U.S. Facilities for Illness Management and Prevention (CDC). The aim of the rules is to enhance the communication between a supplier and their affected person across the threat and advantages of opioid remedy for power ache. The aim is to enhance the security and effectiveness of ache therapy and scale back the dangers related to long-term opioid remedy.
Jerry factors out that the rules exclude managing the ache related to most cancers, end-of-life care or throughout palliative care. The rules use a four-step strategy to deal with evaluation, plan development, medicines and obtainable adjunct therapies.
Throughout evaluation, it’s vital for the supplier to overview whether or not a affected person’s ache is power (greater than three months or previous the time of regular therapeutic) or acute (lower than three months or in step with regular therapeutic).
Different elements assessed embrace the ache’s location, timing, origin and the affect it has on the affected person’s regular operate. As well as, behavioral well being situations considered embrace despair, anxiousness, post-traumatic stress dysfunction, sleep issues, substance abuse and a decline in regular exercise.
Care plan growth
A number of issues are thought-about by the supplier throughout this step. They embrace:
- Explaining that opioids usually are not routine remedy for power ache
- Establishing and measuring targets for ache and performance
- Offering therapy based mostly on the supply of ache
- Discussing the advantages, dangers and availability of non-opioid therapy – equivalent to treatment and different therapies, equivalent to care administration by an OSF ache clinic, bodily rehabilitation or medical train
- Following up at common intervals
At this level, it’s necessary the affected person specific any issues if they’re prescribed an opioid.
“A affected person has the best to ask in the event that they want an opioid for ache management or if there’s another choice equivalent to taking acetaminophen (Tylenol) or a non-steroidal choice (ibuprofen/Motrin) for enough ache management,” Jerry mentioned. “They will additionally ask about different therapies, equivalent to if they’ll use warmth or chilly to assist with ache management together with a non-opioid analgesic or would bodily remedy present them ache reduction.
“You’re your greatest advocate. A person mustn’t hesitate to talk up in the event that they really feel strongly that an opioid shouldn’t be the care path they wish to expertise,” he mentioned.
Different medicines and therapies
Along with acetaminophen and ibuprofen, different various medicines a supplier will take into account are muscle relaxants, numerous medicines for neuropathic ache, topical brokers and disease-modifying medicines.
To handle their ache, a affected person might also be referred to different therapies provided by OSF, equivalent to ache clinic, medical exercising or conditioning, ambulatory diet, rehabilitation, sleep clinic, behavioral well being and smoking cessation.
“Sufferers wanting an alternative choice to opioids ought to talk about with their supplier different first-line treatment choices and adjunct therapies,” Jerry mentioned. “It’s necessary to precise your need to keep away from or decrease the usage of opioids for ache reduction.”
As OSF continues to deal with diminishing the reliance on opioid prescriptions, Jerry mentioned continued schooling of suppliers and sufferers concerning the risks of opioids ranks excessive on the checklist.
“We are also taking a look at initiating medication-assisted therapy applications for sufferers with an opioid use dysfunction,” he mentioned.
There may even be extra consciousness across the elevated must prescribe naloxone (Narcan) for opioid-naïve sufferers and people prescribed a every day dose of fifty morphine milligram equivalents or extra.
If somebody has to take an opioid, Jerry affords the next ideas to take action safely and to maintain their household protected:
- At all times retailer medicines away from kids.
- By no means share your treatment with others.
- Take the opioid on the lowest dose and shortest time frame that gives enough ache reduction.
- Take the opioid for under 48-72 hours if attainable and transition to a non-opioid analgesic.
- Get rid of all unused medicines as quickly as attainable.
Indicators of misuse or abuse
Should you suspect somebody of misusing or abusing an opioid, Jerry urges you to name the Substance Abuse and Mental Health Services Administration (SAMHSA) at (800) 662-4357, which may present assets for the person and their household.
Some signs of misuse or abuse embrace:
- The lack to manage opioid use
- Uncontrollable cravings
- Drowsiness or incapability to remain awake, modifications in sleep habits
- Weight reduction
- Frequent flu-like signs
- Decreased libido
- Lack of hygiene
- Modifications in train habits
- Isolation from household or mates
- Stealing from household, mates or companies
- New monetary difficulties
- Slurred speech
- Irritable or argumentative
Correct disposal of opioids and medicines
“It’s necessary to correctly dispose of opioids and all medications to forestall unintended poisonings or overdoses of youngsters, aged and pets,” Jerry mentioned. “Correct disposal eliminates the temptation for youngsters to experiment with taking opioids. And to forestall medication from getting into into our rivers, streams and ingesting water, don’t place medication down the drain or bathroom to get rid of them.”
To correctly dispose of medication, pay attention to the bi-annual Drug Enforcement Agency drug take back program held in your space. It’s also possible to dispose of medicines at an OSF drug disposal box, some retail pharmacies, equivalent to Walgreens and CVS, and native regulation enforcement departments.
Final Up to date: April 20, 2022