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Healthcare Professionals Mull Realities of Utah’s Opioid Crisis

Salt Lake City—On a rainy Monday morning in downtown Salt Lake City, a group of eleven healthcare professionals and physicians gathered at Holland & Hart for the annual Utah Business Healthcare Roundtable. While Utah ranks No. 7 overall in the United Health Foundation’s national rankings, there are plenty of opportunities for the state to improve its position. Roundtable attendees discussed managing population health and wellness, cost transparency—and what can be done regarding Utah’s growing opioid crisis.

“Even though we’re lowest in alcohol and tobacco use, we’re one of the highest in opioid use and overdose deaths. Because it’s a legal medication that’s acceptable,” said Joe Miner, executive director of the Utah Department of Health. “So you get addicted before you realize what a horrible situation you’re in.”

Miner says that Utah is the fourth-worst state in the nation for its per-capita rate of opioid overdose deaths. According to the Utah Department of Health, one person dies each day in the state from prescription drug overdose, which is a 400 percent increase since 2000.

Part of the problem is that healthcare practitioners overprescribe the medication. Since the 1990s, hospitals and healthcare providers have been “strongly encouraged to measure pain and make sure patients are pain-free in the hospital,” said Miner.

This creates a situation where providers are too eager to prescribe painkillers rather than seek alternative solutions.

“In nursing home, the clinical practice guideline is that for every pharmaceutical intervention you need a non-pharmacological intervention. In all my work there, I don’t know if I ever saw one,” said Juliana Pretson, executive director at HealthInsight. “It’s just not what we think of. We prescribe a pain management pill. We don’t ever have the non-pharmaceutical approach. There are things we’re not tapping for our patients.”

Ed Clark, AVP Clinical Officer for University of Utah Health Science, has tried to work with individual practitioners and medical groups at the university.

“We’ve been working hard on it. Our community physicians at the university—since February, we’ve reduced the number of prescriptions for opioids by 54 percent in that short period of time, using care-process models, using alternative pain therapies,” he said.

The high rate of drug death is exacerbated by low behavioral health resources, said Scott Barlow, CEO of Revere Health.

“I’m excited to see that increasing and resources starting to develop, but there’s still a real shortage of behavioral health [resources,]” he said. “A lot of these issues have a behavioral health element with them, but [there are] not a lot of resources for providers to turn to, to help get that engagement effectively.”

Solving the issue will take a full community collaboration: not only should there be expanded resources, but there needs to also be a cultural shift in how opioids are viewed. Physicians as well as consumers need to be educated on the medications they’ve been prescribed, as well as possible alternatives.

“It’s about public awareness. It’s about physician education. It’s about appropriate disposal that’s starting up for unused drugs, and then especially the integration of behavioral health. I like the point about finding alternatives to manage pain,” said Pat Richards, CEO of Select Health. “So much of abuse is about chronic pain. [We should be] looking at better pain management problems, alternatives—whether it’s acupuncture, massage—because pain is the real issue, and there may be better ways to manage that.”

The discussion was moderated by Dave Gessel, executive VP for the Utah Hospital Association. Read the full conversation in the Healthcare Industry Outlook section of Utah Business’ December issue.