Groups are fighting the opioid epidemic in innovative and unusual ways, from suing the manufacturers, to using big data, to prescribing heroin.
The opioid epidemic is a problem that’s nebulous and dangerous, with no easy answers. Here’s a look at seven innovative, and sometimes unusual, ways hospitals, public health officials, and others are dealing with it.
1. Sue Opioid Manufacturers
Ohio Attorney General Mike DeWine has filed a lawsuit against five prescription opioid manufacturers and their related companies, alleging that they engaged in fraudulent marketing regarding the risks and benefits of prescription opioids that fueled Ohio's opioid epidemic.
The five manufacturers listed as defendants are Purdue Pharma; Endo Health Solutions; Teva Pharmaceutical Industries and its subsidiary Cephalon; Johnson & Johnson and its subsidiary Janssen Pharmaceuticals; and Allergan.
The lawsuit alleges, among several counts, that the drug companies violated the Ohio Consumer Sales Practices Act and created a public nuisance by disseminating false and misleading statements about the risks and benefits of opioids, the attorney general's office said.
2. Employ Big Data and Artificial Intelligence
MAP Health Management and IBM Watson Health are teaming to address relapse among Americans suffering from substance use disorder.
MAP will integrate Watson cognitive technologies into the MAP Recovery Network Platform to enhance the platform's existing capabilities around patient risk models. In doing so, it is anticipated that behavioral health and substance abuse treatment providers who use the MAP platform will be better able to predict and prevent nationwide incidence of relapse.
The companies also report that Aetna Behavioral Health is expected to deploy the Watson-powered MAP offering to help predict substance abuse relapses among its members
3. Get Them off the Market
The FDA requested at the beginning of June that Endo Pharmaceuticals remove its opioid pain medication, reformulated Opana ER, from the market over concerns that benefits of the drug may no longer outweigh its risks.
The FDA said it’s the first time the agency has taken steps to remove a currently marketed opioid pain medication from sale due to the public health consequences of abuse.
The FDA has requested that the company voluntarily remove reformulated Opana ER from the market. Should the company choose not to remove the product, the agency intends to take steps to formally require its removal by withdrawing approval.
4. Treat Pain Differently, Especially in the ED
The Colorado Hospital Association (CHA) launched an opioid safety pilot in eight hospitals and three freestanding emergency departments (FSEDs).
Pilot hospitals and FSEDs will implement the new CO-ACEP 2017 Opioid Prescribing and Treatment Guidelines with the goal of reducing the administration of opioids by ED clinicians.
Treatment guidelines recommend the use of alternatives to opioids (ALTOs), as a first-line treatment for pain rather than opioids. A pilot program is necessary to gather data, establish best practices and determine the efficacy of using ALTOs for the management of acute pain, CHA said.
Unlike opioids which are used for all types of pain, the ALTO technique addresses different types of pain such as kidney stones, migraines, or back spasms, using a specific, targeted approach to address the root causes of the pain.
5. Prescribe Heroin
Health Canada has enabled access to diacetylmorphine (pharmaceutical-grade heroin) through its Special Access Programme, which “provides access to nonmarketed drugs for practitioners treating patients with serious or life-threatening conditions when conventional therapies have failed, are unsuitable, or unavailable.”
Research has shown that prescribing heroin reduces the use of illicit street heroin, which is often associated with overdoses and crime.
So far, the Crosstown Clinic in Vancouver has taken the lead here, saying it’s the the only clinic in North America to offer diacetylmorphine within a “supervised clinical setting to chronic substance use patients.”
6. Use a TimerCap
The California-based company TimerCap offers a prescription bottle cap with a built-in LCD stopwatch timer, which shows the time since a patient has last taken their medication.
It’s also tamper resistant since the clock resets as soon as the bottle is opened, which can alert a patient to someone else taking their medicine.
7. Minimize Early Exposure Risks
Express Scripts has launched an Advanced Opioid Management program that includes education and outreach for to patients when they’re prescribed a new opioid.
In a recent pilot study of more than 100,000 Express Scripts members new to opioid therapy, Express Scripts observed a 38% reduction in hospitalizations and a 40% reduction in ED visits in the intervention group versus the control group during six months of follow-up.
Half of patients received an educational letter from the Express Scripts Neuroscience Therapeutic Resource Center (TRC), and half received no intervention at all. A subset of patients receiving the TRC educational letter who had high-risk patterns of opioid use also received a counseling call from a TRC specialist pharmacist.
Among this subset, Express Scripts observed a 19% decrease in the day's supply of opioid dispensing during six months of follow-up.
Alexandra Wilson Pecci is an editor for HealthLeaders.