Utah | 50 states of population health

MIKELLE MOORE. Senior Vice President of Community Health, Intermountain Healthcare (Salt Lake City)

On the top challenge

"We've been working on an issue that's significant for our patients, [insurance plan] members and others as well, and that's the opioid epidemic."

On the hospital's response  

"We've taken a really bold step. We've been working at a community level with partners for several years, but this past summer we made a pledge within our health system to reduce the number of opioid tablets prescribed for acute pain by 40 percent. We're thinking about this for patients in acute settings like the emergency room, patients who have surgery, as well as how our health plan administers benefits for pharmacies so we can reinforce the same strategies from a member perspective. We're also thinking about strategies for managing chronic pain and opioid use disorders more effectively.

The commitment to a 40 percent reduction in our opioid prescribing was based on a survey of over 7,500 surgical patients, where we found about 50 percent of the tablets we prescribe are unused. We know we can significantly reduce the number of tablets prescribed while still adequately addressing pain. We also learned that a lot of people didn't know how to appropriately dispose of leftover medications, so we've been making a robust effort to educate people about safe disposal. We've installed secure medication disposal drop boxes in all of our pharmacies and helped community pharmacies in rural and underserved communities fund drop boxes. So far, just in system pharmacies, we've collected 18,000 pounds of unused medication.

From a national perspective, it's worth noting at one time Utah was fourth highest in opioid overdose deaths. We're now ninth highest. Utah has been successful due to strong public and private collaborations and a multi-pronged approach. We know we have a lot we need to do to continue to reduce deaths; too many people are dying. But it does appear, at least maybe, that we've stabilized. So we really think it's important we're thoughtful along the continuum about how we reduce our prescribing and how we're helping people get access to treatment for addiction and manage pain more effectively.

We hope that, with this comprehensive approach, we can really mitigate a shift we've seen in some other states, which are seeing multiple generations of opioid dependence translate to really heavy heroin use. An individual can build dependence to opioids in as little as seven days. Many individuals now using heroin initially had a prescription medication. Limiting the supply of opioids through drop boxes and reduced prescribing can help address all opioid addiction and overdose deaths."

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