The University of Michigan is working to cut the number of opioid addictions that result from post-surgical opioid prescriptions, which make up 40 percent of opioid painkillers prescribed overall in Michigan.
Researchers have found that about one in 10 patients who are prescribed opioid painkillers post-surgery become dependent on them. To counter this statistic, as well as an overall high number of prescriptions being given out, the University is working alongside the Michigan Department of Health and Human Services to create the Michigan Opioid Prescribing Engagement Network.
The Michigan-OPEN initiative is being funded with a $1.4 million per year, five-year grant from the state and equal funding from the University with a goal to cut in half both the number of opioids prescribed to post-surgery patients and the number of patients who still used the opioids many months after the surgery took place. Michigan-OPEN will attempt to meet this goal by educating surgical teams about opioid use.
In a statement, Chad Brummett, director of the Division of Pain Research in the UM Department of Anesthesiology and a leading member of Michigan-OPEN, said the initiative would surmount the troubling number of painkillers prescribed by surgeons by giving them the resources they needed.
“Surgeons prescribe nearly 40 percent of opioid painkillers in Michigan, but have few resources to guide them on best use of the drugs by patients before and after surgery,” Brummett said. “We hope that by working with surgical teams across the state, we can fill that gap for the benefit of individual patients and our state as a whole.”
Several medical students have also worked on this initiative. Ryan Howard, a fourth-year medical student who took charge of a project specific to reducing prescriptions after gallbladder surgery, said he thought the initiative was imperative and surgeons especially had a greater responsibility in it.
“I think this is really critical work right now,” Howard said. “In Michigan, more people die from opioid overdose than from car accidents. Since surgeons prescribe roughly 40 percent of the opioids in the community, they have a huge opportunity to help address this issue. What we’re trying to do at UM is model a way to really comprehensively make a difference in the safety of our patients and our community as a whole.”
Michigan-OPEN is being coordinated alongside 12 Blue Cross Blue Shield Michigan Collaborative Quality Initiatives. These CQIs are composed of medical professionals and hospitals throughout Michigan that work together to improve surgical care.
Together, Michigan-OPEN and the CQIs will create guidelines for surgical professionals, such as primary care and specialty physicians who treat surgical patients. These guidelines include tactics for hospitals to deal with patients and health care providers.
The Michigan-OPEN initiative will also put a special emphasis on Medicaid patients. While this demographic only accounts for 12 percent of surgical patients in the state, it makes up 30 percent of people who become dependent on opioid painkillers after surgery.
Along with the effort to prevent post-surgery opioid addiction, Michigan-OPEN additionally plans to focus on patients who were already taking prescription opioid painkillers before they had surgery.
Additionally, the University has also created a guide for organizing opioid take-back events. Typically, pills can only be disposed of at government agencies like police stations. These take-back events, which have interactive maps to direct people to the nearest locations, have proven to be effective — one event in Ann Arbor collected approximately 89,500 pills, most of which were prescribed post-surgery.
Howard, who also ran a project to increase access of locations to dispose of leftover opioid pills, stressed the uncertainty patients had about where they should dispose of their medication.
“Many of the patients we spoke with knew it was dangerous to have leftover medication lying around, but they simply didn’t know where to take it,” he said.