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    Four health systems develop opioid mitigation programs


    The opioid epidemic not only has taken more than half a million lives from 2000 to 2015, but the rate of opioid prescribing has quadrupled in the United States over the past three decades, according to the CDC.

    Four healthcare systems have taken the opioid crisis to heart and developed programs focused on reducing unnecessary opioid prescribing and identifying alternative therapies.

    Summit Medical Group

    “It is important to recognize how we reached an opioid crisis,” says Laura Balsamini, director of pharmacy services for Summit Medical Group, a physician-owned practice with more than 550 practitioners headquartered in Berkeley Heights, New Jersey. “The road to prescribing opioids by physicians was paved with good intentions. They received encouragement at medical school to be more aggressive about keeping patients comfortable and to not let them suffer. There was not enough training or education about potential risks.”

    New Jersey has some of the strictest laws governing the use of opioids. Signed last February, a new law restricts the initial prescription of opioids to five days for those suffering from acute pain. New York, Massachusetts and Maine have enacted laws limiting initial prescriptions to seven days.

    The New Jersey law also requires state-regulated health insurers to cover the first four weeks of outpatient and inpatient treatment for opioid addiction without requiring prior authorization and provide up to six months of coverage for treatment.

    Finally, the new legislation encourages physicians to use the state prescription monitoring program (PMP) to prevent abuse; record a patient’s medical history, including substance abuse addiction; and discuss potential risks of opioids and alternatives to these drugs, such as Tylenol, NSAIDS, physical therapy, yoga, acupuncture—all of which must by documented in a patient’s electronic health record (EHR).

    Summit is leading a campaign to educate physicians on these new state requirements and joining a national campaign to combat the opioid crisis, Turn the Tide Rx, initiated by the U.S. Surgeon General. Summit’s multi-prong approach to reducing the use of opioids for long-term chronic pain include:

    1. Using the state’s PMP;

    2. Educating patients about risk;

    3. Providing alternative treatments;

    4. Establishing an agreement between physicians and patients stating that patients can only receive an opioid prescription from one doctor and no more than two pharmacies; and

    5. Mandating CME every two years on responsible opioid practices; alternatives to opioids for managing and treating pain; and risks and signs of opioid abuse, addiction, and diversion.

    “The opioid crisis is a double-edged sword,” Balsamini says. “While addiction has already caused lots of damage, if physicians stop the flow of prescriptions, patients might turn to something else such as heroin. But we can prevent future lives from being negatively impacted by educating patients and collaborating with physicians.”

    Next: St. Joseph's Healthcare System


    Mari Edlin
    Mari Edlin is a frequent contributor to Managed Healthcare Executive. She is based in Sonoma, California.

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