Opioid – The Health Care Blog

RWJF Opioid Challenge: You Can Help

Jan 29, 2018• 3

By CHELSEA POLANIECKI AND CHANLY PHILOGENE

Opioid overdoses are the leading cause of death for Americans under 50 years old. In fact, the majority of drug overdose related deaths involve an opioid. According to the National Center for Health Statistics, deaths from prescription opioids—drugs like oxycodone, hydrocodone, and methadone—have more than quadrupled since 1999. The U.S. is currently experiencing an opioid epidemic, as more than 2 million Americans have become dependent on, or abused prescription pain pills and street drugs. Substance misuse is not only affecting the users but also their families, friends, and the healthcare system as a whole.

Although improvements have been made to the way opioids are prescribed through clinical practice guidelines, the epidemic has continued to grow. The CDC has made several efforts to combat substance misuse and overdose but there is much more to be done, and you can help. The Robert Wood Johnson Foundation (RWJF) is committed to supporting those affected by this issue and launched the RWJF Opioid Challenge live, at Health 2.0’s Wintertech conference in January 2018. This innovation challenge calls for tech-enabled solutions that help identify resources, facilities, and educational content for support, as well as platforms for connecting patients, caregivers and peers for peer community.

RWJF has teamed up with Catalyst @ Health 2.0 to identify and incentivize the development of tech-enabled solutions that should aim to support affected individuals (e.g. opioid users, caregivers, peers, family, etc.) and connect them to relevant resources. Every individual faces a different set of challenges, meaning that needs for recovery can be unique and varied.* The challenge is calling on innovators, developers, entrepreneurs and other bright minds to create tools to support those affected by opioid misuse.

Reducing Opioid Abuse, A Quick Guide to Internet Resources

Nov 1, 2017• 9

By DAVID HARLOW, MD

The opioid crisis has been upon us for years now, and we are now seeing the problem become more pervasive, with more than 90 deaths per day in the U.S. due to this scourge. The president recently said he would be declaring a public health emergency (which would free up some funds) but has not done so as of this writing. The public health threat is so persistent that it calls for responses on many levels, and those responses are coming. Some have been in place for a while, some are more recent. These responses may be broken down into a number of different categories:

Broader availability of naloxone (antidote) and related training to first responders, health care providers and the general public (though of course in our litigious society, applicability of Good Samaritan laws to naloxone use by laypersons is a consideration)
Medication-assisted treatment following acute episodes (emergency room visits)
States imposing limits on prescribing and dispensing, mandating education and other innovations (for example, Massachusetts’ first-in-the nation opioids law (including the first state law limiting most opioid prescriptions to a seven-day supply), enacted in 2015, with a follow-up law enacted in 2016 that among other things offers a system for recording and communicating a voluntary opiate “opt-out” for individuals); and limiting pharma payments to physicians in order to discourage incentives for high-prescriber status (current proposal in New Jersey)
Licensure and certification bodies imposing limits on prescribing and dispensing (state boards of registration in medicine, e.g., Ohio) and articulating management and operations frameworks for implementing those limits (Joint Commission)
PBMs establishing limits for dispensing (Express Scripts, CVS Caremark)
Payors imposing limits on payment (see, e.g., Cigna‘s opioid abuse detection and prevention program)
The FDA mandating prescriber training (it is also being urged to ban high-dose formulations)
Providers developing programs to limit the use of opioids in pain management along with specific targets on reduction in use (e.g., Intermountain)
Professional and industry associations providing training of clinicians in pain management without opioids, or with limited opioid use (e.g., Massachusetts Medical Society, Colorado Hospital Association)

The overarching goal is to eliminate the use of opiates for all but the most critical short-term needs (limiting prescriptions to a seven-day supply) and medically-appropriate chronic and palliative pain management. There are alternative pain relief drugs — and a wide variety of other treatments for pain, ranging from TENS to meditation to VR. Taken together, the initiatives highlighted and linked to above represent a good start. Of course, we need more than a good start, as the US consumes a wildly disproportionate share of opiates compared to other countries — follow link for some facts and figures — for predictable reasons of economics, politics and culture, and we are paying a staggering price in excess morbidity and mortality and in secondary effects (the effects on family and community).