Kaiser Reduces Potential Opioid Abuse
Kaiser Permanente's efforts to reduce the number of opioid prescriptions being written by its providers have paid significant dividends.
Over the past three years, Kaiser's Southern California division has been able to drastically reduce the number of prescriptions dispensed that provide large large doses of the medication, as well as switch the vast majority of recipients to generic equivalents. Both changes are key to deterring abuse of the prescription drugs, officials say.
Since Kaiser launched what it calls the Safe and Appropriate Opioid Prescribing Program in 2011, high-volume opioid prescriptions (regimens that typically contain 100 milligrams or more of painkiller a day) have been cut by 91%. And when generics are available in lieu of brand-name painkillers, Kaiser has been able to transition its patients 95% of the time to that alternative.
Both changes make it far less likely that patients would sell all or a portion of the medications for profit – an issue that has become nearly endemic with opioid painkillers. Pills with lower concentrations of opioids are less desirable in the black market, as are generic versions. The initiative has focused primarily on curbing misuse of Vicodin and Oxycontin.
“Opioid over-use and abuse is a public health epidemic,” said Michael Kanter, M.D., director of quality and clinical analysis for the Southern California Permanente Medical Group. “It’s not just about cutting dosages of drugs. It’s about having a program that will benefit the patient, and provide relief of pain without putting the patient at risk for complications of opioid overuse. It requires many professionals in different specialties providing input.”
According to data from the Centers for Disease Control and Prevention, 259 million prescriptions for painkillers were written in 2012 – enough for every adult in the nation to have a bottle of pills. The rate of overdose and death from such medications has risen 400% among women since 1999, and 265% among men, killing about 17,000 Americans annually. Heroin deaths have also doubled during that time, with the CDC concluding that many who are abusing prescription painkillers turn to heroin when they cannot obtain a steady supply.
The trends have spawned dramatic growth in laboratory testing to ensure patients are adhering to the prescription regimens, as well as higher rates of incarceration for prescription fraud.
And, as Payers & Providers reported last month, the rate of hospitalizations for patients suffering heroin overdoses has more than doubled in recent years.
Hospitals in Los Angeles County recently embarked on their own joint initiative to try and reduce prescription drug abuse by refusing to replace lost prescriptions, dispsense alternative medications and check a statewide computerized database of active prescriptions.
