An Innovative Approach to Curbing the Opioid Epidemic
“I was alarmed,” said Dr. Allen Beguin. “I’d read about the opioid crisis, of course, but when I read survey results that one in five students at the local schools my kids were on track to attend were using prescription drugs recreationally, I knew we had to do something.”
Fortunately, Beguin was in a position to take action through his medical leadership role at Winona Health, a Minnesota hospital. “One of the very first things I brought to the table was the need to get some control over narcotics,” said Beguin.
Reducing the Flow of Opioids Into the Community
Beguin set to work and was again startled by what he found. “We looked at the refilling patterns, and there were several patients who were refilling their pain medications two or three weeks early every single month,” he said. “That means in the course of a year they had they acquired almost six months’ worth of medication above and beyond what they should have used.”
Where was that extra medication ending up? Beguin feared he knew the answer: the community and, ultimately, the schools.
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With Beguin’s leadership, Winona Health immediately took two steps to provide stronger monitoring of patients who were prescribed opioids. First, the hospital ended the practice of allowing over-the-phone opioid refills. Second, it required patients receiving opioid prescriptions to see a doctor face-to-face every three months. Beguin hoped both of these measures would stem the flow of excess opioids into the community.
Turning the Tide on Opioid Addiction
But that was only half the problem. Opioids are not always the most effective way to treat pain and can carry a higher risk of addiction than other alternatives.
So a team of Winona Health primary care providers and clinical staff developed a new process for treating pain by opening the Conservative Management Clinic (CMC), a dedicated pain management clinic aimed at helping patients find the safest, most effective treatment options to lessen their pain. All hospital primary care staff are required to rotate through the CMC for professional education on painkiller potency and alternative pain management options.
“We Created a Guideline for Optimal Doses of Medication for Patients.”
Now, if a medical professional at Winona Health determines that opioids are the best course of treatment, they use prescribing guidelines to give the patient the lowest effective dose that treats pain and carries the lowest risk for addiction.
The clinic also makes patients aware of the addictive risks associated with opioids, providing information in tandem with alternative pain management options including cognitive, physical and behavioral therapy as well as other alternatives like mindfulness.
Minnesota’s Hospitals Strengthen Communities
The results of the CMC team’s efforts are impressive. Since the launch of the CMC, Winona Health has experienced a 25 percent drop in the number of opioid prescriptions issued and a 30 percent drop in the average dosage patients receive. For Beguin, the biggest success goes back to his original call to action. “Twenty-five percent of the supply is gone, so that’s a 25 percent reduction in the amount of opioids that are available to the middle and high school population,” he said.
Opioid abuse isn’t unique to the Winona area. In 2015 alone, 216 Minnesotans died as a result of opioid overdoses, and many more experienced addictions to narcotic pain medications. You don’t have go far to see how addiction affects your neighbors, loved ones and friends; it touches every Minnesota community. Preventing and treating opioid addiction is a shared community responsibility. Minnesota’s hospitals are working to create local solutions to respond to the opioid crisis, but they can’t do it alone. It will take a statewide investment and coordinated response to turn the tide on the opioid epidemic.