Hill Country Memorial's role and response to a national crisis of abuse
The U.S. is seeing an explosion of opioid abuse that is killing people, destroying families and causing lasting harm to our communities.
That should not surprise anyone who pays even casual attention to the news. The desperation of those with opioid addiction is well-documented in the media and being felt first-hand by too many families in our community.
Helping lead that fight is a priority for Hill Country Memorial. Our unique point of view as clinicians is seeing opioid abuse as a public health issue, and our role is putting controls in place to appropriately safeguard against misuse of opioid analgesics (painkillers).
The irony is, of course, that opioids are medications that have their roots in well-intentioned efforts to effectively treat pain. They are designed to attach to the brain’s opioid receptors to muffle perceptions of pain.
Clinicians know pain is a complicating factor in people’s ability to heal. As a medication, prescribed opioids are effective at treating pain; at higher doses they slow a person’s breathing and heart rate and can lead to death.
The number of deaths from opioid abuse, and the rate of increase in recent years is sobering. In 2016, more people in the U.S. died from opioid abuse (64,000) than in the Vietnam War (58,000). There were 1.8 deaths per 100,000 Texans from opioid overdoses in 2000. In 2016, the number had risen to 13 deaths per 100,000. In 2017, we saw 51 opioid-related visits to the HCM emergency department. Naxalone, (marketed as Narcan), an effective way to reverse an opioid overdose, was administered eight times, reflecting the severity of the situation in those cases.
At the core of Hill Country Memorial’s approach to the opioid crisis is a set of multi-model pain therapies and guidelines for opioid use. Those guidelines start with a recommendation to use non-opioids for mild to moderate pain, and to combine opioids with non-opioids to manage moderate to severe pain.
Guidelines have been established for administration of opioids to patients in the hospital, where use can be monitored, and dosing guidelines set out for both opioid and non-opioid analgesics.
In the outpatient setting, our clinicians consult the Texas Prescription Monitoring Program website prior to prescribing Schedule 2 narcotic prescriptions and utilize electronic prescribing for greater control outside the inpatient setting.
In October 2017, the U.S., government officially declared the opioid epidemic a public health emergency, making it a top government priority.
At HCM we see our role consistent with that framing of the issue as a matter of public health. We are working hard to put safeguards in place to prevent opioid abuse before it becomes an addiction, and to educate physicians and patients to make informed choices in the management of pain.
At Hill Country Memorial, we are putting resources and energy behind the efforts to find solutions to the opioid crisis. For those who want to join us in that effort, we welcome you. For those who are struggling with or have a family member with an opioid addiction, please reach out to us.
Help is here, and we are committed to addressing the challenge of opioid abuse in the spirit of a public health emergency.
Dr. Partin is Chief Medical Officer at Hill Country Memorial.