by CMS staff report
Featured in the July/August 2018 Colorado Medicine.
Colorado currently has the nation’s 12th highest rate for misuse and abuse of prescription opioids. Beginning in June 2017, the Colorado Hospital Association (CHA) and its member hospitals conducted a six-month pilot in eight Colorado hospital emergency departments (EDs) and two freestanding emergency departments (FSEDs) with the goal of reducing the administration of opioids by ED clinicians.
This initiative, one of the largest opioid research efforts in the United States, used treatment guidelines developed by the Colorado Chapter of the American College of Emergency Physicians (Colorado ACEP) that recommend the use of alternatives to opioids (ALTOs) as a first-line treatment for pain rather than opioids.
All participating members successfully implemented the pilot, which returned remarkable results. The EDs achieved a 36 percent reduction in opioid administrations when compared to the same time period in 2016, far surpassing the original pilot goal of a 15 percent reduction. This amounted to a projection of 35,000 fewer individual opioid administrations between the 2017 pilot and the 2016 baseline period.
The changes in ED pain management behaviors were dramatic, and the usage of ALTOs increased to the point that they became more commonly administered than opioids for some diagnoses in the treatment of pain. The pilot facilities treated a combined total of 130,631 unique patients during the six-month pilot period.
Pleased with the results of the pilot, CHA President and CEO Steven Summer said, “These results suggest that the opioid crisis in Colorado could be significantly reduced by a widespread implementation of the ALTO treatment guidelines and that is something we know our member hospitals and health systems are very interested in pursuing.”
“The potential that opioid prescriptions carry for addiction and abuse made the need for these guidelines clear,” said Donald Stader, MD, Colorado ACEP secretary, ED assistant medical director Swedish Medical Center. “My colleagues and I are very excited by the pilot results. It appears that we are one step closer to solving the opioid crisis in Colorado.”
For more information and additional details about the results, visit www.cha.com/opioid.