The U.S. continues to experience rising opioid overdoses but Oregon's numbers are declining. Why?
While the rest of the country is seeing huge increases in the volume of opioid overdoses and opioid-triggered emergency room visits, Oregon’s numbers are dropping dramatically. What is happening in the state to lessen the devastating effects of this terrible crisis?
This article discusses a number of steps the state of Oregon has taken to equip physicians to better help patients who may be at risk for opioid addiction. How have these steps caused the rate of opioid deaths to steadily decline? Could the state be a model for the rest of the country?
Oregon Opioid Deaths Decreasing – Three Big Shifts in Clinical Policies
According to an article in The Fix, Oregon’s opioid death rate has dropped by 25 percent. At the same time, the Center for Disease Control suggests the national opioid epidemic has dramatically spiked; deaths from opioid overdose were five times higher in 2016 than in 1999.
But not in Oregon. Clinicians suggest that one of the key changes the state has undertaken has been to respond quickly to the Center for Disease Control’s (CDC) new recommendations that say, “Higher doses of opioids are associated with higher risk of overdose and death – even relatively low doses increase risk.”
The practical applications of these guidelines are that medical students in Oregon are being taught to aggressively follow the CDC guidelines for opioid prescribing. In 2016, the organization released new guidelines suggesting opioids work best only for short-term pain relief. The fact that Oregon reacted so quickly by changing the teaching in medical schools and residency programs is unusual; an OBP article points out that clinical providers are traditionally slow to follow changes in these types of guidelines.
With the opioid epidemic in full swing in the United States, Oregon reacted quickly to the CDC’s changes by forming a task force that implemented new guidelines at clinical teaching facilities around the state. This has lessened the pressure on Oregon drug rehab facilities, as the ripple effect is being felt around the state.
While the clinical guidelines were being implemented, the task force realized that monitoring the prescriptive behavior of clinical providers was also important. The state implemented an electronic database of patients, so physicians could track which ones were exhibiting possible drug-seeking behavior. It also tracks the volume of opioid prescriptions physicians are writing and even allows doctors to compare the number they have written against what their peers are prescribing. These platforms are particularly helpful in providing oversight; one study suggested that physicians have no way to compare if their prescriptive habits are out-of-step with their peers.
The third effective step that Oregon is taking is that drug rehab facilities in Oregon and surrounding areas are some of the best in the nation, providing patients with medication-assisted-withdrawal and a variety of behavioral and therapeutic treatment approaches in both inpatient and outpatient settings. Having access to alternative therapies such as acupuncture and physical therapy can also help patients suffering from chronic pain, providing them with an outlet other than prescription opioids.
Together, these approaches are clearly working, proving that Oregon continues to lead the rest of the country in the effective treatment of substance use disorders.