Intermountain Healthcare has launched an initiative to promote awareness, education and safe use of prescription opioids in response to the opioid crisis in Utah.
Meanwhile, Dr. Jennifer Plumb, one of its top pediatric doctors at Primary Children’s Hospital, was also named to the state opioid crisis task force.
In its 2017-19 Implementation Plan, Primary Children’s targets prescription opioid abuse as one of its prevention goals. That goal extends throughout the Intermountain network, said Lisa Nichols, community health executive director for the system.
During its triannual community needs assessment, Intermountain identified prescription opioid abuse as a startling statistic among morbidity and mortality rates, Nichols said.
Utah has often ranked in the top 10 among states for deaths from opioid abuse, she said. In addition, the state has one of the higher prescribing rates for opioids in the U.S., Nichols said.
“We decided to give a concerted effort to the crisis,” she said. “We decided to do it as a health system. We collaborated with the Utah Department of Public Health. We said it would be a priority. We’re bringing all of our resources to the table to be aligned in that approach.”
Initially, Intermountain utilized an external approach, collaborating with members of the opioid community to erect billboards, provide public service announcements, encourage conversations with providers, and provide disposal drop boxes in strategic locations, Nichols said. Users have now disposed of about 18,000 pounds of medication in those eight drop boxes, she said.
For public awareness and education, Intermountain providers partnered with community leaders to introduce “new thinking” about prescriptions, discuss the dangers of opioids, and suggest ways to talk to patients about the issue, Nichols said. The campaign eventually provided training to about 2,500 providers, she said.
In its third prong, Intermountain launched an initiative promoting access to treatment, an area in which Utah has been slow to the game, Nichols said.
Intermountain donated funds to Davis Behavioral Health and Weaver Human Services, where about 390 low-income, underinsured patients were able to receive treatment, she said.
“We have had really good outcomes at keeping people in treatment,” Nichols said. “Eighty-five percent of those in treatment are substance free of opioids. That is a really great rate.”
Meanwhile, the organization has used the treatment ideas used to deliver those successful outcomes to train 49 other organizations to implement treatment programs in Utah, she said.
After training its providers internally, Intermountain saw only a 10 percent decrease in opioid prescriptions, so it raised the bar to a system-wide goal of a 40 percent reduction in January, Nichols said.
The system surveyed 7,500 patients after surgery and discovered they were using only 50 percent of the opioids they were prescribed, leaving unused medication as a risk to children and teens, she said. Sharing those survey results with providers has helped keep Intermountain on track for its goal of a 40 percent reduction, Nichols said.
Plumb, who is associate professor of pediatrics at University of Utah and medical director of Utah Naloxone, launched the latter program to offer the overdose reversal medication after discovering that no such programs existed locally, she said.
In addition to serving on the state task force, she participates in opioid community collaboration programs with Intermountain and a university cooperative program run by the state Public Health Department.
“All these entities are trying so hard to bring together different groups,” she said. “You can only have so many committees before it feels like your work is just committee meetings. The task force brings together the DEA, the governor’s office, (Utah) Speaker (of the House Gregory) Hughes and me. It needs to be a nimble, let’s-get-things-done arm. We’ll see how it manifests in the coming years.”
The goal of the task force is to gather the recommendations of professionals in the field addressing the crisis from different angles, including the abuse-recovery community, those working to reduce overdoses, prescribers and law enforcement, Plumb said.
“We want to take their ideas and put them into action,” she said.
Although Utah was fourth in the nation in prescription opioid deaths in 2014, the state dropped to seventh in 2015 and 21st in 2016, Plumb said. This drop occurred even though Utah’s death rate remained relatively unchanged, she said.
“Other states have leapfrogged us,” Plumb said. “We’re trying to take a positive look. It appears to have at least stemmed the tide for now. That’s something.”