With the world's attention understandably focused on a global pandemic, the deadly opioid epidemic has been bumped from the headlines over the past two years. Yet, it's front-page replacement has acted as an accelerant to the physical and emotional pain driving opioid use disorder (OUD) to new heights.
According to the Centers for Disease Control and Prevention, of the nearly 71,000 drug overdose deaths in 2019, more than 70 percent involved an opioid. Those numbers have increased at an alarming pace with recently released CDC preliminary data showing a record high 93,000 overdose deaths in 2020.
While opioid overdoses were already on the rise pre-pandemic, the CDC released an official Health Alert Network Advisory at the end of 2020 warning of substantial increases in drug overdose deaths involving synthetic opioids. The alert noted the largest increase in fatalities was recorded from March to May 2020, coinciding with national lockdowns associated with the initial wave of the pandemic.
Observing a perfect storm of conditions fueling this rise, Nashville-based HealthStream has expanded their approach to opioids to focus on creating a culture of safety, rather than a singular focus on compliance. A leading source of workforce and provider solutions across the nation, HealthStream is leaning into education, stewardship and health equity to offer healthcare executives and leaders a different perspective on increasing opioid awareness and training. While it remains critical to comply with prescribing guidelines and evidence-based treatment protocols, the hope is taking a broader view of the pervasive epidemic crossing all population segments will lead to new understanding, compassion and solutions.
"HealthStream has been around for over 30 years. Our vision has been to improve the quality of healthcare by developing those who deliver care," noted Trisha Coady, senior vice president and general manager for Workforce Development Solutions at HealthStream. Addressing the rise in opioid-related fatalities, Coady added, "As we look at what's happened in healthcare across the country, our focus is really on helping frontline staff."
Partnering with the National Quality Forum and Just Health Collective, HealthStream is working on programming that creates a structured approach to opioid stewardship while also drilling down to look at healthcare access ... and just as importantly, to upstream issues and solutions.
In August, just ahead of International Overdose Awareness Day, the group hosted a national conversation on opioids. Experts in quality, equity and the judicial system discussed the impact of the opioid crisis across all sectors of society and looked at collaborative opportunities, equity, inclusion, resources and innovative concepts to help save lives.
"Education is one of the least expensive tools in the toolbox that has one of the most broad-reaching impacts," noted Coady, a nurse and national thought leader on professional development. She added, education needs run the gamut from enhanced awareness of OUD, implicit bias and microaggressions to guidelines for adhering to evidence-based prescribing and the deployment of community education around Narcan.
However, Coady is quick to point out complex issues like OUD require a multi-pronged approach to finding effective, long-term solutions. "People come to the ER and are sent out without a treatment plan. We don't have enough places for people to recover," she said of the need for more physical resources.
Breaking down silos is another important step to comprehensive care, Coady continued. Pointing to diabetes care, she noted there is a strong emphasis on prevention, care coordination and patient education. "We're not yet connected as a system with opioids the way we are with diabetes," she said, adding OUD requires the same mindset. "It really is a chronic condition, and we need to treat it that way."
In addition to the physical toll, the cost of OUD in terms of providing care and lost productivity is in the billions and continues to rise each year. While there have been positive steps for both opioid stewardship and addressing barriers to care, Coady said the pandemic exacerbated underlying issues and shone a light on how much more work remains to be done when it comes to achieving health equity.
"As the pandemic stabilizes at some point, we're going to be left with issues that need to be tackled. There will be such a hill to climb," said Coady. Education alone won't resolve the opioid epidemic, she continued, but it's a foundational platform for launching initiatives within healthcare and community settings to begin to scale that mountain.