The opioid epidemic was already a national health crisis before the pandemic, and the arrival of COVID-19 created the perfect storm among many vulnerable populations. Based on a webinar featuring a panel discussion on the current state of the opioid epidemic, this blog post explores the threat of these compounding public health crises. Featured in the conversation are panelists Trisha Coady, Senior Vice President and General Manager of Workforce Development Solutions at HealthStream, Meredith Gerland, Senior Director of Quality Innovation at the National Quality Forum (NQF), Duane Reynolds, CEO and Founder of Just Health Collective, and Deborah Taylor Tate, Director of Administrative Office of the Courts for the Tennessee Supreme Court.
Gerland shares that in the face of the pandemic, addressing the opioid crisis has become even more challenging. She explains, "The opioid and substance use disorder crisis has continued to be amplified by the COVID-19 pandemic. And the convergence of these two public health emergencies has really led to an increase in an acceleration in overdose deaths. As information continues to emerge related to some of the longer-term impacts of the pandemic, it's really become increasingly clear that individuals with substance use disorder have been disproportionately affected by this disruption to daily life that we've all faced over the past year and a half." The following four steps can help organizations in the battle against these overlapping crises.
There has been a 30 percent increase in opioid-related deaths between 2019-2020, with approximately 250 daily deaths related to opioid overdose occurring in 2020. More than 54 percent of people know someone who has died from a drug overdose. Further, some 8.7 million children are in households with at least one parent with a substance use disorder—leading to a 100 percent increase in children entering foster care system due to parental drug since 2000.
The annual cost to U.S. hospitals related to opioids has been estimated at over 20 billion. Related to this is the fact that systemic bias, impacting a large portion of those affected by the opioid epidemic, additionally creates a huge financial burden. The annual direct cost economic burden of health inequities is over half a trillion dollars (57.5 billion dollars). Hospitals cannot afford to see these numbers continue to skyrocket, especially during a pandemic.
Individuals with a recent diagnosis of substance use disorder, particularly opioid use disorder, are at a significantly increased risk for COVID-19, and individuals with substance-use disorder and COVID-19 had worse outcomes compared to other COVID-19 patients. Gerland points out, "The mental health ramifications of social distancing and isolation also have far-reaching impacts for everyone, but especially for those with substance-use disorder and in particular opioid use disorder."
A new approach to education is needed if we are going to see change. Coady points out, "Building a culture of safety and belonging takes time. It takes education on evidence-based care, creative partnerships, and shared best practices." The following three steps guide organizations in shifting from a compliance focus to centering on organizational culture and the commitment to change:
"We're at a point in the evolution of our health care system where health equity is no longer just a nice thing to have," Reynolds explains. "When I think about diversity, equity, inclusion, what I term 'belonging,' it's really foundational to the culture of an organization in order to be able to then move towards health equity. It is a capacity, knowledge, and skillset that every healthcare organization really needs to have no matter where you are in this country."
If organizations are going to address the major systemic issues their patients face, it is critical to frame their understanding from a health equity perspective. Explore HealthStream solutions that cultivate a culture of belonging by empowering a diverse and inclusive workforce.
Acknowledging that healthcare providers must be supported in their implementation of national guidelines on appropriate pain management, NQF identified a series of seven fundamentals with actionable strategies, barriers and solutions, and resources to help implement practical on-the-ground strategies. Gerland emphasizes, "The goal of an opioid stewardship program is really to focus on safe and appropriate use of pain management strategies and not to just blindly reduce opioid prescribing."
For more information about opioid-related education, explore HealthStream and NQF's National Quality Partners Playbook on Opioid Stewardship.
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