How Are You Treating the Opioid Epidemic in 2021?
In the face of the COVID-19 pandemic and the opioid epidemic, treating and strengthening a community is a difficult challenge. As we move beyond the statistical surges of the COVID-19 pandemic, providers must refocus on the opioid epidemic and the long-term effects of addiction and risks of overdose escalated by the disruption of care due to the pandemic.
Opioid Trends During the COVID-19 Pandemic
Decrease of Urine Drug Tests & Increase in Dangerous Drug Combinations
In the shadows of the COVID-19 pandemic, increased opioid overdoses were expected due to disruption of care and mental health and economic distress. The most recent data from the Centers for Disease Control and Prevention (CDC) suggests a record high 27 percent increase in overdose deaths as compared to pre-pandemic months. The COVID-19 pandemic limited the opportunities for patients to receive face-to-face provider care and made it more difficult for patients to provide urine samples for clinical drug testing due to stay-at-home orders and changes in policy during the pandemic.
Workers’ Compensation Claims & Chronic Pain
Another trend seen with opioids is prescribing habits and their industry-specific nature. Employees suffer higher injuries in industries such as construction, farming, and manufacturing. With the increase in addiction centered on vulnerable populations, nonprofits (foster care systems and drug treatment facilities) have experienced higher volumes and pressures without increased budgets. These workplace injuries and policies on workers’ compensation have the potential to lead to chronic pain and the ongoing use of opioids with little to curtail the impact on the affected workers’ families.
Drug Manufacturer Liability for the Opioid Epidemic
Public health trends of the opioid epidemic have identified that “the majority of persons with opioid addiction started with prescribed painkillers” as opposed to illicitly obtained drugs. For this reason, the opioid epidemic, spanning over three decades now, is the cornerstone of many high-profile legal cases looking to place accountability on drug manufacturers. The CDC has extensive tracking on the litigation and resources on the topic and has succinctly stated:
“Even as the amount of opioids prescribed and sold for pain has increased, the amount of pain that Americans report has not similarly changed. From 1999 to 2019, nearly 247,000 people died in the United States from overdoses involving prescription opioids. Overdose deaths involving prescription opioids more than quadrupled from 1999 to 2019.”
– CDC Opioid Overdose Overview
What Is Your Organization’s Plan?
Chart a Path Forward
With no changes in reported pain levels nationwide, and an early promise from drug manufacturers that opioids are not addictive, what is your organization’s plan?
Whether you treat acute pain, manage chronic pain, or provide addiction care, you should investigate the current processes and reassess the appropriate use of controlled substances at your facilities.
Compiled below is a list of questions you can ask when thinking about strengthening your chronic pain and opioid prescription guidelines and processes. These questions cover both quality and compliance opportunities. Shifting focus back to quality care requires a reconciliation of policy and process.
- Organizationally, do you have compliance thresholds for opioid prescription volume?
- Do you use electronic prescribing data averages and baselines to track number of prescriptions of controlled substance per location, provider, and department as well as determine outliers?
- Is your leadership team involved in opioid risk management?
- How often are prescribing volumes and outliers reviewed?
- Organizationally, do you conduct regular provider training?
- How do you respond to suspected abuse?
- Audit controlled substance wastage.
- Monitor controlled substance storage.
- Do you offer non-opioid pain treatment per policy and in practice?
- Do you audit for and have access to a consent form for long-term controlled substance therapy?
- This opens a conversation up between provider and patient about the risks and benefits of opioid therapy for chronic pain.
- Is the form offered in languages that serve your patients?
- Do you complement an opioid prescription with:
- A Naloxone prescription?
- A referral to behavioral health?
- Do providers have tools to track and measure realistic goals for pain and function (pain scale in EMR)?
BKD realizes the importance of clinically appropriate pain management. In conjunction with the lasting effects of the COVID-19 pandemic, providers must use their clinical judgment to manage pain safely and effectively.
Leveraging and monitoring your data and knowing your organization’s baselines can be a new journey, and BKD can help.
Our Opioid Interactive Tool identifies prescribing patterns and helps keep organizations on the right track by identifying and monitoring high-risk outliers and prescribing practices. Data-driven steps take control back and put a spotlight on excessive prescribing without blame or finger pointing. It is a critical time to guide your dedicated providers along this post-pandemic course. We recommend organizations take an active role to ensure that process follows policy moving forward.
For more information on our Opioid Interactive Tool, reach out to your BKD Trusted Advisor™ or submit the Contact Us form below.