The opioid epidemic is devastating communities, families and individuals across Colorado and the country. On average 130 Americans die every day from opioid overdose; it was responsible for 560 deaths in Colorado 2017. And for every death, there are many more people struggling with opioid addiction.
To address the expansive scale of the crisis, the CU Anschutz Medical Campus is marshaling its resources across the spectrum of health fields. Here are some examples.
Coordinating Colorado’s opioid response
CU Anschutz is the home of the Colorado Consortium for Prescription Drug Abuse Prevention, which coordinates Colorado’s statewide response to the opioid epidemic. Operated out of the Skaggs School of Pharmacy and Pharmaceutical Sciences under the direction of Professor Robert Valuck, the consortium’s members include faculty from each of our schools and colleges, in addition to representatives from state agencies, law enforcement and community coalitions. The consortium consults with state lawmakers about legislation, coordinates public awareness campaigns, and helps train doctors on safe prescribing practices and members of the community on how to reverse overdoses. It also supports public awareness campaigns and medicine takeback programs.
Since its establishment in 2013, this pioneering collaboration has leveraged state and institutional investments to attract more than $30 million to address drug abuse. Its innovative approach has been cited in analysis of successful responses to the opioid epidemic.
CU Anschutz’s work is culminating in the creation of the Center for Prescription Drug Abuse Prevention, which will also be housed at the Skaggs School of Pharmacy and Pharmaceutical Sciences, starting in the summer of 2019. The new center will continue to host the Colorado Consortium for Prescription Drug Abuse Prevention, and will also facilitate interdisciplinary research; identify and promote evidence-based clinical practices; educate health care and public health practitioners; and test, implement, and promote new models of care for the treatment of pain and substance use disorders. The center will give the CU Anschutz community an opportunity to collaborate and coordinate our work, and our vision is for the center to become a national leaders in research, education, and community engagement
Educating health professionals
To address the shortage of health professionals equipped to deal with the opioid epidemic, CU Anschutz offers a number of trainings, certificates and degrees. The Colorado School of Public Health launched both a certificate and an MPH concentration in Population Mental Health and Well-Being, addressing mental health and substance use from a population perspective. Both programs are set to begin in Fall 2019.
CU Anschutz physicians developed a one-click tool, launched at UCHealth University of Colorado Hospital in 2017, that allows busy emergency room staff to instantly see how many prescriptions a patient has filled at other locations.
Cognizant of the fact that dentists write about 12 percent of opioid prescriptions, the School of Dental Medicine offers continuing education programs to educate practicing dentists on newly developed guidelines for prescribing pain medications and best practices for discussing pain and opioids with patients.
Online continuing education courses for health professionals in opioid stewardship and preventing prescription drug abuse are operated by the Center for Health, Work and Environment in the Colorado School of Public Health. Seminars on campus have included an opioid education day, hosted by the Physical Therapy Program last fall, addressing improved approaches to pain management; a training on the signs of opioid overdose; and an International Overdose Awareness Day event that included a hands-on demonstration of how to obtain and administer Naloxone, or Narcan, a drug that reverses opioid overdoses.
Research to better understand the science of addiction
Inside our labs, researchers are seeking to answer questions at the heart of the epidemic. One study revealed how emergency department physicians underestimated how often they prescribed opioids. Another used health data to predict who would use opioids after hospitalization. Other studies – too numerous for an inclusive list – have ranged from prescription of opioids by veterinarians to opioid use and misuse following treatment for head and neck cancer to the varying rates of opioid prescriptions at veterans hospitals.
Developing clinical solutions
One way CU Anschutz is helping deliver quality care to address opioid addiction is illustrated in the story of Nicholas Antonio. Nicholas’s experience as a survivor of the Columbine school shooting 20 years ago led to significant post-traumatic stress disorder, and he turned to opioids to cope. After a downward spiral that included jail time, he finally found the help he needed at the Sheridan Health Services clinic, operated by the CU College of Nursing. There he received medication-assisted treatment (MAT), a whole-patient approach that combines FDA-approved medications with counseling and behavioral therapies. The approach not only worked for Nicholas; it has proven so effective in treating opioid addiction that governments at all levels are expanding access to it. State funding enabled CU Nursing to extend MAT training in Pueblo and Routt counties, and a federal grant to the School of Medicine expanded access across 24 additional rural Colorado counties.
Meanwhile, CU Anschutz physicians developed a one-click tool, launched at UCHealth University of Colorado Hospital in 2017, that allows busy emergency room staff to instantly see how many prescriptions a patient has filled at other locations. Should abuse be suspected, doctors can adjust their treatment plan accordingly. Then, depending on their addiction severity, patients can be referred for inpatient treatment at the Center for Dependency, Addiction and Rehabilitation (CeDAR) and/or to outpatient community programs such as the Sheridan Clinic’s MAT that combine medication-based approaches with behavioral treatments to help patients maintain sobriety.
Where to next?
The epidemic continues to rage on, but there are some reasons for hope. Since 2014, the number of opioid prescriptions written by Colorado physicians has dropped by more than 200,000 (from 4 million to 3.8 million). And they’ve dropped even more dramatically at Colorado emergency rooms that participated in a pilot program to reduce opioid use – including University of Colorado Hospital’s ER, which has trimmed its opioid prescription from 20 percent to 8 percent of patients in the past three years.
Now the consortium and other state entities are devising a plan to take the opioid-reduction strategies from the ER program to the rest of the hospital. The idea is to bring together specialty doctors’ groups and get them working on guidelines tailored to the nuances of each specialty that will result in fewer opioid prescriptions.
These are just some of the broad-based efforts CU Anschutz is undertaking to combat the opioid epidemic. With a mission of improving the well-being of the communities it serves, CU Anschutz is responding to the seriousness and the complexity of the crisis broadly, and in concert with many other institutions. There is no single fix, but by attacking it from all sides we are making progress.