Healthcare providers and hospitals are changing their approaches to treat pain and addiction. They are implementing new prescription guidelines, creating personalized systems of care and addressing addiction as a disease rather than a moral failing.
Everybody has to start this at about the same time said Dr. Halena Gazelka, director of inpatient pain services within Mayo Clinic’s pain medicine division, during a panel discussion on hospitals' role in the opioid epidemic during U.S. News' annual Healthcare of Tomorrow conference.
The University of Vermont Medical Center had to change the mindsets of physicians to confront the opioid crisis said Dr. Alicia Jacobs, vice chair of clinical operations and a family medicine physician with the University of Vermont Medical Center.
Jacobs said that it should be realized that this is a chronic, relapsing, remitting disease. This is just like diabetes with chronic relapsing. That is what is needed to apply to this population as well.
Aligning with Vermont’s hub-and-spoke system for opioid addiction, providers affiliated with the medical center have integrated drug treatment into their practices. Jacobs said that these patient-centered medical homes offer a team approach to address a patient’s health issue and promote a healthy lifestyle. This kind of care has to be normalized and integrated into what we do everyday.
Jacobs also mentioned that if we are going to address chronic disease and bend the cost curve into value-based care, then a model has to be created where we leverage our primary care work for us. Later the patient will see a specialist.
Christopher Freer chairman of Saint Barnabas Medical Center’s emergency department in New Jersey said that they and other RWJBarnabas Health facilities have integrated peer recovery specialist programs into their emergency departments to help patients with substance use disorder.
After observing how receptive both staff and patients were to the specialists – who themselves are in long-term recovery from substance use disorder and provide intervention and support – Freer said they're spreading the services into in-patient units as well.
Gazelka said in terms of reconstructing hospitals’ prescription habits, Mayo Clinic has developed its own recommendations for acute and chronic pain prescriptions based on the guidelines mentioned by the Centers for Disease Control and Prevention and others.
Jay Bhatt, senior vice president and chief medical officer of the American Hospital Association said that support for those suffering from opioid addiction should not stop once the patient leaves the hospital. The conversation that has been accelerating around social needs, social determinants, health equity, stigma are all not separate from the issue of opioid use disorder.