As prescriptions for opioid painkillers increased dramatically over the last two decades, so too did the opioid epidemic.
According to the Centers for Disease Control, U.S. doctors wrote 259 million prescriptions for painkillers in 2012. While prescription rates have declined slightly since 2010, the CDC also says “sales of prescription opioids in the U.S. nearly quadrupled from 1999 to 2014, but there has not been an overall change in the amount of pain Americans report.”
So when it comes to the opioid crisis, the connection (or is it causality?) isn’t hard to see.
But now at least one healthcare provider is pledging to do its part to turn the tide. But they aren’t looking to reduce the number of prescriptions, only the prescription orders.
Utah-based Intermountain Healthcare, which operates 22 hospitals and 180 clinics, recently announced a plan to reduce “the average amount of opioids prescribed per acute pain prescription” by 40 percent by the end of 2018. Simply put, they won’t be reducing the actual number of prescriptions, but the number of pills per script.
The company said patients often have a significant number of pills left over once their pain subsides, leading to abuse by the patient or their friends and family members. They hope that by reducing the number of opioids available per prescription, they will create less waste and reduce the risk of problematic use.
“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,” Dr. Doug Smith, associate medical director for Intermountain Healthcare, said in a statement. “We will follow best practices in prescribing, so the medications prescribed more closely match the needs of patients.”
To accomplish their goal, “Intermountain is adding prompts and default order sets into its electronic health records to help reduce the number of tablets prescribed,” according to their statement.
In a move that should please treatment professionals and advocates for chronic pain patients alike, the company said they will offer alternative pain management and treatment methods to make sure patient needs are still being met. They claim to have already trained over 2,500 staff members on the new initiative and will be expanding their training program in the near future.
Still, questions remain about how effective the new policy will be in reducing substance use disorders and problematic use. Many people addicted to prescription medications already engage in “doctor shopping,” or switching doctors to obtain more opioids when a prescription runs out. Intermountain’s new tactics may only force them to switch more frequently.
Intermountain also did not reference any study or research to back their plan, and The Influence staff were unable to find any significant information to support the hypothesis that fewer pills per prescription would reduce addiction rates. Still, it’s reasonable to assume that removing 5 million opioid tablets annually (Intermountain’s estimate should they reach their goal) would have a positive effect in one form or another.
But of course it’s also clear that the opioid epidemic is not contained to Intermountain’s patient base, and fighting the epidemic will require systematic change nationwide. Will other providers follow Intermountain’s model? Only time will tell.