The Utah-based health care provider Intermountain Healthcare announced last week that they plan to reduce opioid prescription by 40 percent by the end of 2018.
According to the Utah Department of Health, 282 Utahns died from opioid overdose in 2015. Dr. Todd Brown, the medical director of Logan Regional Hospital, said the national and local focus on the opioid crisis led Intermountain Healthcare to re-evaluate their practices surrounding the drugs.
“Patients dying because of the use or misuse of opiates makes us realize that maybe what we’re doing isn’t the best thing to be doing,” he said.
Many opioids are categorized as Schedule II drugs by the Drug Enforcement Administration. Dr. Brown said the protocol for these Schedule II opioids, like Dilaudid or Percocet, sometimes contributes to patients getting more pills than they need after a procedure or an injury.
“We have to write them out, they have to face to face visit, but you can’t refill it,” he said. “So if a patient gets 10 and they need 12, they need to re-engage the doctor to get those medications again. So what we do is give them more than they need so that doesn’t happen.”
He said this comes from a desire to keep patients from having no way to treat their pain after running out of medication outside of business hours.
“We err on the side of giving them enough, so they don’t run out on a weekend or a holiday or in the evening,” he said. “As a result, the procedure gets better, the injury heals, and the patient is left with a quantity of medications that they don’t need because they may have needed them.”
To achieve the 40 percent reduction, Intermountain Healthcare has trained about 2,500 of the caregivers in its system, with plans to offer the training to more providers. They will also add prompts and default order amounts to their electronic health record system and work to expand patient education programs, pain management clinics, and therapy options.
Intermountain Healthcare is still building its plan to reduce opioid prescriptions. Dr. Brown said committee meetings about potential solutions are ongoing and will likely lead to new guidelines for best practices.
“I’m just glad that we’re talking about this,” he said. “As a primary care provider, I appreciate guidance. This whole dialog and public awareness campaign helps us to be partners with our patients to help them not get in trouble with a scary class of medications.”