The number of drug overdose deaths in the US is staggering.
An estimated 500,000 Americans have died from opioid overdoses in the last two decades, according to the Centers for Disease Control and Prevention (CDC) statistics from 1999 to 2019.
More than 70,000 died from drug overdoses in 2019 alone.
And 50,000 were from opioid overdoses, with 15,000 dying from prescription opioid overdoses.
“Illicit drug use is dangerous and deadly,” said Kim Compagni, assistant vice president of pain management at Intermountain Healthcare in Salt Lake City, Utah, a state that is making progress in the battle.
“There are many factors that have continued to contribute to the crisis,” Compagni told Anadolu Agency. “Illicit drug trade, unsafe opioid prescribing practices and lack of access to treatment,” she said.
It is not just the amount of deaths that has been sounding alarms. The overall use of illicit drugs is eye opening.
More than 41 million Americans had a substance use disorder in the past 20 years and 9.5 million misused prescription opioids, according to the CDC.
The opioid crisis has been hiding in plain sight for decades and addressing the problem head-on is one of the purposes of the United Nations International Day against Drug Abuse and Illicit Trafficking, known as World Drug Day.
“It is important to bring awareness to this issue,” said Compagni. “Too many people are lost to drug overdose deaths and/or have their lives and those of their loved ones negatively impacted.”
World Drug Day was first observed June 26, 1989. In its 33rd year, the UN is using the platform to strengthen action and cooperation in achieving a world free of drug abuse.
While bringing public awareness to the crisis in the US is an important mission, actions speak louder than words.
Intermountain Healthcare, a Utah based not-for-profit system of 33 hospitals and 385 clinics, has been striving to put a safe prescription medication plan into action since 2017, and the results are impressive.
“Intermountain has worked diligently to create protocols for prescribing, as well as working on access for treatment and partnering with community groups to help underserved communities get vital help in this area,” said Compagni.
In the past 5 years, Intermountain Healthcare has prescribed 12 million fewer opioid tablets to patients, drastically reducing the amount of unused opioids in medicine cabinets.
Instead of automatically filling a 30-day prescription, doctors are prescribing medications on an as-needed basis.
“We looked at past national prescribing practices and found that some conditions were getting a 30-day supply when they only really need around three days to get through that initial pain cycle,” said Compagni. “If a patient had an acute care condition, the goal was to educate the patient on pain management alternatives to opioids or fill a prescription for up to three days, the time needed to get through the initial pain.”
“The message that we want people to hear is that some pain is expected, especially after a surgery, and the goal is not always to be pain free,” she said. “Some pain, that is manageable, is actually helpful because it could be a sign of an underlying problem, such as an infection after a surgery.”
In addition to reducing pain medication prescribed to patients, Intermountain Healthcare in 2021 began cutting high-dose, high potency opioid tablets, otherwise known as morphine-milligram equivalents (MME).
“The higher the MME of an opioid, the higher the potential risk for addiction and overdose,” said Compagni. “Intermountain was able to cut the percent of high dose opioid prescriptions over 90 MME from 14% to just under 6%.”
Intermountain has also introduced naloxone to patients, which can reverse an opioid overdose. Naloxone is not a controlled substance, does not lead to addiction and can be administered via an injection or nasal spray.
“Having naloxone in the house is critical to anyone who has been prescribed opioids, especially when children live in the home,” said Nicholas Weaver, pharmacy technician lead at Intermountain Healthcare’s Primary Children’s Hospital.
“A child who accidentally ingests an opioid can easily overdose and die from the injury,” he said. “Naloxone can reverse the effect and save a little one’s life if used in a timely manner.”
It is for that reason why Intermountain has provided naloxone kits to at-risk patients and since 2017 has reported more than 7,500 overdose reversals.
“Ensuring that loved ones, friends and co-users have and know how to use naloxone in the event of an overdose is a proven effective lifesaver,” said Weaver.
In the last five years, Intermountain has also implemented medicine-safe boxes and envelopes to collect unwanted prescription tablets to ensure they do not fall into the wrong hands or are misused.
A total of 45,000 unused medicines have been collected during that time.
“These changes are huge wins for improving patient safety and keeping patients safe from potential addiction, misuse or even unintentional overdose,” said Compagni. “(We are) thrilled with the outcomes of these changes.”
Intermountain practices may just be a microcosm of what is working in Salt Lake City, but if the same strategy and model were implemented in other health care systems across the country then perhaps the mission of World Drug Day to eradicate drug abuse, addiction and deaths in the US could make significant progress in the future.
“In the state of Utah, we have approximately a 50% market share so our efforts are only impacting about 50% of the patient population,” said Compagni.
“Implementing similar solutions in other health systems would have a great impact on their overall patient safety.”/aa
