Intermountain Healthcare has pledged to reduce the average number of opioid tablets we prescribe per acute pain prescription by 40 percent by the end of 2018. That means we’ll cut the number of opioid tablets we prescribe by more than 5 million annually. Intermountain is the first U.S. health system to formally announce such a significant and specific target.
Doug Smith, MD, Intermountain’s Associate Medical Director, says patients will still be able to get the medications they need, but we want to reduce the number of excess pills they get. “Currently, nationwide, providers tend to write prescriptions for more opioids than patients need, and large quantities of the medications are often left over after the need for pain relief is past,” he said. “We'll follow best practices in prescribing so the medications prescribed more closely match the needs of patients.”
Marc Harrison, MD, Intermountain’s CEO, told CNBC: “We really want to make sure we reduce the potential for abuse but still ensure that our patients have high-quality care. This is a big goal, but our communities and the people in them are suffering, and we need to do something about that.”
Some studies have shown that two-thirds of all opioids that are misused and abused come from family members or friends. Others become addicted even when they’re using the medicines as directed.
“Seven years ago, when I had cancer surgery, I took opioids,” Dr. Harrison told Forbes. “I could see how somebody could get in trouble. I could see how regular people could end up crosswise with this and end up with a problem.”
Here are Intermountain’s plans to achieve the 40 percent reduction:
- Caregiver training. Intermountain has already provided training to about 2,500 Intermountain caregivers, and we plan to expand training to additional prescribers in Utah and Idaho.
- Prompts and default order sets will be added to our electronic health records to help encourage a reduction in the number of tablets we prescribe.
- Our drug database system monitors prescriptions and provides clinicians with real-time information on their prescribing practices so they can make improvements as needed.
- More educational services for patients will be offered.
- Pain management therapies will be offered to patients.
Intermountain also plans to expand other services—such as pain management clinics and treatment resources for opioid use disorders—to better help patients with chronic pain or addiction. Intermountain will also step up efforts to make sure naloxone, used to treat overdoses, and suboxone, used to help patients stop taking opioids, are available to those who need them.
In 2015, 24 people died each month in Utah from prescription opioid overdose, according to Utah Department of Health data. From 2013 to 2015, Utah ranked seventh in the nation for drug overdose deaths.
“The epidemic of opioid misuse is a giant problem for the U.S. healthcare system, but Intermountain’s campaign could have an impact,” reported Healthcare Dive. “The Salt Lake City-based system … could be an inspiration for other provider groups that want to address the issue.”
Intermountain's opioid initiative has received a lot of media attention nationally and internationally. More than 181 million people have seen stories in such outlets as The Wall Street Journal, CNBC, and Forbes Business Insider.