Opioid misuse is considered to be a major health problem in the US and a leading cause of injury-related death. The rate of overdose death related to the use of opioids has drastically increased over the last couple of decades (Centers for Disease Control and Prevention, 2019). Opioid-related overdose death rates and prescribing rates vary widely across different states. West Virginia’s opioid-related overdose death rate of 43.40 was one of the highest in the US in 2016 (Scholl, Seth, Kariisa, Wilson, & Baldwin, 2018, p. 1422). This is threefold higher than the national opioid-related overdose death rate of 13.3 in 2016 with a total of 42,249 drug overdose deaths (Scholl et al., 2018, p. 1422).
In turn, West Virginia’s drug overdose death rate involving prescription opioids is 19.7, whereas the national average is just 5.2. In 2015, West Virginia healthcare providers wrote 110 opioid prescriptions for 100 persons, compared to the average US rate of 70.6 prescriptions (Centers for Disease Control and Prevention, 2018, para. 8). Alarming rates for West Virginia highlight the need to mobilize a national and state response to the opioid epidemic.
Three types of prevention interventions have been identified in order to decrease the alarming opioid crisis with its staggering death rates. Primary prevention intervention focuses on opioid misuse prevention before it even occurs. A good example of such an intervention is dissemination and implementation of prevention programs that promote safe storage and disposal of opioids. It is assumed that prevention programs offered to teenagers and adolescents can effectively reduce the misuse of opioids in the selected population. These programs can be delivered in various settings and tailored to the attributes of specific communities. This intervention may be of particular importance to young people as individuals usually initiate drugs misuse when they are under the age of 18.
Secondary prevention intervention that could be considered is screening for opioid misuse. Routine screening for drug misuse using the opioid-risk tools can assess clinical risk for opioid abuse among people who are prescribed opioids. It may be assumed that screening can reduce opioid-related overdose death rates and address opioid prescription rates. Tertiary prevention intervention relates to the specific intervention that reduces harm or consequences of opioid misuse for individuals who already have a drug misuse disorder. An example of such an intervention may be the treatment of opioid use disorders and the provision of naloxone to prevent opioid-related overdose death.
The evidence-based strategy that could effectively reduce provider opioid prescription rates is the prescription drug monitoring programs (PDMPs). PDMPs are electronic databases that collect, analyze, and monitor prescriptions written to individuals on a state level. Pharmacies and dispensing practitioners submit the data to the PDMPs, and healthcare providers can access them to see patients’ prescribing histories.
Policies may be implemented to require that healthcare providers check their state PDMPs to inform their prescribing decisions. Thus, the main stakeholders charged with addressing the opioid crisis in my community are pharmacists, healthcare providers, and dispensing practitioners. There is evidence that the implementation of such intervention can improve opioid prescribing and protect patients who are at risk (Bao et al., 2016). Apart from reducing the use of multiple healthcare providers, the implementation of PDMPs can reduce opioid-related overdose death rates. It is worth mentioning that PDMPs are active databases that can be utilized by the health department to plan and evaluate interventions.
References
Bao, Y., Pan, Y., Taylor, A., Radakrishnan, S., Luo, F., Pincus, H. A., & Schackman, B. R. (2016). Prescription drug monitoring programs are associated with sustained reductions in opioid prescribing by physicians. Health Affairs, 35(6), 1045–1051.
Centers for Disease Control and Prevention. (2018). U.S. opioid prescribing rate maps. Web.
Centers for Disease Control and Prevention. (2019). CDC’s response to the opioid overdose epidemic. Web.
Scholl, L., Seth, P., Kariisa, M., Wilson, N., & Baldwin, G. (2018). Drug and opioid-involved overdose deaths — United States, 2013–2017. Morbidity and Mortality Weekly Report, 67(5152), 1419–1427.