California Hospital Cuts Opioid Prescriptions by Half, Recurring ED Visits by 60%

County-wide initiative addresses overdose crisis

Every day, 44 people die of overdose from prescription opioids in the United States. Community Hospital of Monterey Peninsula (CHOMP) in California has taken action to address the crisis in its county of approximately 415,000 residents. The community-wide effort, called Prescribe Safe, includes the county’s four hospitals, the district attorney’s and sheriff’s offices, public health clinics, and urgent care centers.

The initiative has led to a sharp decline in the number of patients coming to the emergency department (ED) because of opioid abuse and in the number of prescriptions for opioid painkillers, according to an article in AHA News.

The Prescribe Safe group established guidelines for prescribing pain medications in the ED that are followed by all hospitals in the county. It has contributed to a 50% decline in opioid prescribing by physicians.

“It is not that we don’t want to treat pain; we don’t want to treat every pain with opioids as we used to,” said CHOMP emergency physician Casey Grover, MD.

Every patient who comes into an ED in the county is given a handout––in English and Spanish––about prescribing safe pain medications. They also receive a list of community resources for drug and alcohol counseling and providers of alternative pain treatments, such as acupuncture.

In addition, Prescribe Safe taught providers how to talk to patients about drug use without judgment. Providers work with law enforcement agencies to crack down on cases of unlawful purchase or distribution of opioids and other prescription painkillers.

CHOMP has referred more than 600 patients––those who had been frequently admitted to the ED for drug-related reasons––to care-management programs that address their specific medical or behavioral needs. Since the program’s inception, recurrent ED visits related to opioid abuse have dropped nearly 60%. 

The Prescribe Safe program offers a model for other health care organizations that are seeking to address opioid misuse and abuse in their communities, according to Anthony Chavis, MD. “The resources are out there,” he said. “You don’t have to re-invent the wheel.”

Source: AHA News; May 26, 2016.