An initiative led by the University of Michigan and the state's department of health aims to educate hospitals and surgical teams and to slash post-surgery prescriptions by half.
Surgeons prescribe nearly 40% of opioid painkillers in Michigan, and about one in 10 patients become dependent on them following surgery, University of Michigan researchers have determined.
To address both issues, the University of Michigan is working with the state to educate surgical teams about opioid use through the Michigan Opioid Prescribing Engagement Network (Michigan-OPEN). The goal is to cut in half both the amount of opioids prescribed to Michigan surgical patients, and the number of patients who still use opioids many months after surgery.
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Michigan-OPEN will be funded by a $1.4 million-per-year, five-year grant from the Michigan Department of Health and Human Services, and equal funding from University of Michigan. The project will work with 12 Blue Cross Blue Shield Michigan Collaborative Quality Initiatives (CQIs), which are networks of physicians, nurses, and hospitals across Michigan that collaborate to improve surgical care.
The CQIs will distribute information about how to understand and use best practices for pain control in their patients.
The team hopes that the information will help not only providers, but also state policymakers and insurance plans combat the opioid epidemic.
Chad Brummett, MD, director of the Division of Pain Research in the U-M Department of Anesthesiology, and surgeons Michael Englesbe, MD, and Jennifer Waljee, MD, MPH, MS will lead a team that will collect, analyze, and share information about opioid prescribing patterns in the state.
"Surgeons prescribe nearly 40% of opioid painkillers in Michigan, but have few resources to guide them on best use of the drugs by patients before and after surgery," Brummett said in a statement. "We hope that by working with surgical teams across the state, we can fill that gap for the benefit of individual patients and our state as a whole."
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Michigan-OPEN will work with each CQI to create "bundles" of tactics targeted to both patients and healthcare providers, that each hospital can use to reduce opioid prescribing and dependence. This includes strategies geared toward not just surgeons, but also primary care and specialty physicians who care for surgical patients before and after their operations.
The Michigan-OPEN effort will put special focus on Medicaid patients, who account for 12% of surgical patients in the state but make up 30% of people who develop a dependence on opioids after surgery.
In addition to addiction prevention in patients whose first opioid experience happens with surgery, Michigan-OPEN will focus on patients who were taking prescription opioids before they had surgery.
The university has also created a guide to holding a take-back event as well as a map of all known drug take-back locations in the state, and will encourage hospitals to hold drug take-back events in their communities.
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These efforts can be effective: A recent drug-return event in Ann Arbor collected approximately 89,500 pills, and most of those were prescribed following surgery. The oldest opioid pill turned in was prescribed in 1990.