The focused work by Nebraska hospitals to reduce their opioid use deserves applause. During 2013-18, Nebraska health systems lowered opioid prescriptions by some 32%. That’s encouraging progress in heading off the kind of full-blown opioid crisis that unfortunately burdens some other states.
Nationwide, 43,036 Americans died from painkiller overdoses in 2017, a figure exceeding the toll from car-crash fatalities.
The positive examples from Nebraska hospitals are many. Here is a sampling from recent reporting by The World-Herald’s Julie Anderson:
» CHI Health has reduced or eliminated the drugs from a variety of surgical procedures.
» Creighton University Medical Center-Bergan Mercy has reduced the drugs for all surgeries by an estimated 50% or more, with the figure varying from procedure to procedure.
» Methodist Health System during 2017-18 reduced inpatient and outpatient opioid prescriptions by 750,000 pills, a reduction of 12%.
» Opioid prescriptions per 1,000 patient days at Nebraska Medicine fell by 35% between July 1, 2016, and March 31.
» Faith Regional Health Services in Norfolk reduced its inpatient opioid use by about a third from December through February by broadening its pain management strategies to include objective signs of pain such as heart and respiratory rates.
An additional encouraging factor: cooperation from patients in helping decrease the resort to such pain management drugs, given their powerful addictive potential.
“The more media coverage we’ve had on this crisis, the more engaged and aware patients are, and they proactively want to protect their own health,” says Elizabeth Becker, director of performance improvement and quality at Jennie Edmundson Hospital in Council Bluffs.
Medical providers in the Midlands are using state databases of drugs dispensed to people, allowing improved monitoring of prescriptions and protections against doctor-shopping as a way to circumvent prescription limits.
The Nebraska Legislature has taken a commendable bipartisan approach for years in approving legislation to improve monitoring and provide safeguards on the opioid issue. A recent change in Nebraska law, for example, has strengthened the ability of medical providers to use electronic medical records across state lines for opioid monitoring.
Nebraska Attorney General Doug Peterson has focused on the opioid issue and promoted coordination among organizations to address it. The Nebraska Department of Health and Human Services has issued voluntary prescription guidelines for medical professionals to reduce excessive reliance on opioids.
The concern over pain medication encompasses dental practice, too. A report this year in JAMA Internal Medicine described the vulnerability of young dental patients, ages 16 to 25, to opioid addiction. The study found they were more than 10 times more likely than their peers to be diagnosed with opioid abuse within a year of getting a prescription. Insurers and the American Dental Association have stepped up their focus on opioids, recommending sensible limits on prescriptions.
All involved in addressing the opioid problem deserve a salute. Ongoing diligence and collaboration are needed against this fearsome threat.