The Opioid Use Reduction Initiative
According to the Centers for Disease Control and Prevention, more than 750,000 people have died since 1999 from a drug overdose. Two out of three drug overdose deaths in 2018 involved an opioid. Every day, hospitals and health systems see the effects of the nation’s opioid epidemic.
RWJBarnabas Health has been working to address this public health issue for many years. The system began its work with the formation of the Tackling Addiction Task Force. This Taskforce is a multi-disciplinary group of practitioners focused on: education, prevention, recovery, intervention and treatment. The taskforce empowered the RWJBarnabas Health Emergency Room Collaborative and the Pharmacy Enterprise to create an Opioid Stewardship Program. An Opioid Stewardship program is coordination of interventions designed to improve, monitor and evaluate the use of opioids in order to support and protect human health.
This collaboration led to the development of the system DROP (Deliberate Reduction of Opioids) program led by the RWJBarnabas Health Institute for Prevention and Recovery.
This group has completed a number of steps to reduce opioid prescribing and increase access to treatment for opioid addiction:
- Clinician education on prescribing practices
- Creation of evidence-based order sets for pain management across entire system that focus on multimodal pain management to minimize opioid use
- Creation of opioid withdrawal prevention and treatment policy and order set/protocol for all sites
- Continual monitoring of opioid and alternative agent use at all sites through data analytics report converting all opioid prescriptions to morphine equivalents.
- ED and Inpatient review of disease states with highest levels of opioid use
The RWJBarnabas Health System underwent an EHR conversion in 2023 in the majority of the acute care facilities. As a result of the conversion, better data was captured on patients discharged with opioids. Continued surveillance throughout 2024, will determine if increase extends beyond data capture conversion.
The number of patients discharged from the ED decreased 23.7% from 2022 to 2023 and the number of ED patients discharged with an opioid prescription slightly decreased from 2.028% in 2022 to 2.025% in 2023. Given the 23.7% decrease in ED discharges from 2022 to 2023, we would have expected to see 10 more ED patients discharged with an opioid prescription.
In 2022, the Pharmacy Enterprise partnered with the RWJBarnabas Health Institute for Prevention and Recovery (IPR) and Rutgers Opioid Overdose Prevention Network (OOPN) to begin distributing naloxone. From second to fourth quarter of 2023, 676 naloxone kits were distributed to patients through IPR’s peer recovery specialists.
