Intermountain seeks to cut opioid prescribing 40% by end of next year

Intermountain Healthcare is looking to cut by 40% the number of opioids prescribed for acute pain across its entire system by the end of next year.

Utah's largest hospital system announced Tuesday that it will seek to reduce the number of opioids prescribed throughout its 22 hospitals and 180 health clinics. The ultimate goal is to prescribe 5 million fewer tablets by the end of 2018.

The move follows similar albeit not as ambitious efforts to reduce opioid prescribing by a number of healthcare providers in recent years. The prescriptions have driven opioid abuse for the past two decades.

According to Lisa Nichols, Intermountain's community benefit director, the system has already trained about 2,500 of its caregivers on better prescribing habits. Nichols said Intermountain has also developed a drug database system that monitors prescriptions and provides clinicians with real-time information on their own habits.

"We want that data to be available really on a very regular basis so people (prescribers) understand how they are doing," Nichols said.

In 2015, Utah ranked ninth among states with the highest drug overdose mortality rates with more than 23 deaths for every 100,000 residents. Nichols said more than 80% of those who become addicted to heroin began by using prescription opioids.

"Certainly, we want to do what we can to decrease opioid overdose deaths and misuse in the state of Utah," Nichols said, adding they are not planning on offering alternatives.

More than 33,000 Americans died from opioid overdose in 2015, according to the Centers for Disease Control and Prevention. That's led other providers to step up to combat the problem as well.

In June, eight hospitals and three free-standing emergency departments in Colorado collaborated with the state's hospital association to employ new ED prescription guidelines from the state's chapter of the American College of Emergency Physicians.

A 2014 study in the journal Academic Emergency Medicine found that between 2001 and 2010, the percentage of ED visits where an opioid was prescribed grew from 20.8% to 31%. A New England Journal of Medicine study published in February found wide variation among physicians working in the same ED, with some doctors more than three times more likely than their colleagues to prescribe opioids for the same medical conditions.

The rate of opioid prescribing has fallen nationally by 13% from 2012 to 2015. But the number of opioids prescribed in 2015 remains three times higher than in 1999, according to the CDC.

Nichols said years of misinformation on the dangers of opioids as well as trying to meet the patient demand to treat pain were factors that led to continued overprescribing.

"We've created a culture where we expect to be completely pain-free," Nichols said.

A JAMA study published Tuesday suggested that EDs might also be more helpful in curbing addiction by more regularly dispensing medication-assisted treatment such as buprenorphine. The study found that only 33% of heroin overdose survivors and 15% of prescription opioid overdose survivors had been dispensed buprenorphine, naltrexone or methadone within six months of an overdose. Studies have shown that the faster treatment is offered, the more successful the addict's recovery.