Colorado has the 12th-highest rate of prescription opioid abuse and misuse in the nation, according to the Colorado Hospital Association.

“We looked at that [rate] and said, ‘What can we do to help in this epidemic? ’How can we specifically focus on opioid abuse and misuse?’” said Diane Rossi MacKay, CHA’s clinical manager of quality improvement and safety.

To get started, in 2016 CHA reached out to the Colorado Chapter of the American College of Emergency Physicians (CO-ACEP), the Colorado Consortium for Prescription Drug Abuse Prevention, the Colorado Emergency Nurses Association, and quality-improvement organization Telligen.

Together, they formed the Colorado Opioid Safety Collaborative, which helped them pool their expertise and come up with a six-month opioid safety pilot program that launched earlier this month.

For the pilot, eight hospitals and three standalone emergency departments—selected to reflect the diversity of facilities in the state—agreed to adhere to new CO-ACEP 2017 Opioid Prescribing and Treatment Guidelines, which MacKay said are unique to Colorado.

“Other guidelines pretty much tell physicians what they cannot do,” MacKay said. For instance, there are some organizations around the country recommending that physicians reduce the number of pills in opioid prescriptions. In its own guidelines, the Colorado Opioid Safety Collaborative has suggested that physicians and clinicians participating in the pilot first use and prescribe alternatives to opioids (ALTOs), which are non-opioid medicines or treatments that are very specific to the pain a patient is experiencing.

For example, someone walking into an ER with a migraine would get a different ALTO than someone experiencing kidney stones, whereas before they both may have received IV opioids and opioid prescriptions to take home with them. With these new recommendations, opioids would be a second-line of defense rather than the knee-jerk reaction they’ve become.

During the pilot, the collaborative will be collecting data, such as patient satisfaction around pain management, the reduction of the use of opioids, and the reduction of opioid prescriptions. With that data, the collaborative hopes to build some best practices around using ALTOs, which can then be shared with hospitals around the state and even the country. In fact, other state hospital associations have already contacted CHA, seeking advice for their own opioid programs.

“Our specific goal is to reduce overall administration of opioids by 15 percent,” MacKay said. “But the bottom line is that we want to really have an impact on the use and abuse of opioids.”

 

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