The Opioid Use Reduction Initiative

According to the Centers for Disease Control and Prevention, more than 750,000 people have died since 1999 from a drug overdose. Two out of three drug overdose deaths in 2018 involved an opioid. Every day, hospitals and health systems see the effects of the nation’s opioid epidemic.

RWJBarnabas Health has been working to address this public health issue for many years. The system began its work with the formation of the Tackling Addiction Task Force. This Taskforce is a multi-disciplinary group of practitioners focused on: education, prevention, recovery, intervention and treatment. The taskforce empowered the RWJBarnabas Health Emergency Room Collaborative and the Pharmacy Enterprise to create an Opioid Stewardship Program. An Opioid Stewardship program is coordination of interventions designed to improve, monitor and evaluate the use of opioids in order to support and protect human health.

This collaboration led to the development of the system DROP (Deliberate Reduction of Opioids) program led by the RWJBarnabas Health Institute for Prevention and Recovery.

This group has completed a number of steps to reduce opioid prescribing and increase access to treatment for opioid addiction:

  • Clinician education on prescribing practices
  • Creation of evidence-based order sets for pain management across entire system that focus on multimodal pain management to minimize opioid use
  • Creation of opioid withdrawal prevention and treatment policy and order set/protocol for all sites
  • Continual monitoring of opioid and alternative agent use at all sites through data analytics report converting all opioid prescriptions to morphine equivalents.
  • ED and Inpatient review of disease states with highest levels of opioid use
    • Targeted education and order set review for these disease states
    • Created protocols for use of alternate agents to decrease opioids and provide pain management
  • Multi-site research on opioid alternatives such as lidocaine and ketamine
    • Developed guidance (policy/education/order set) for providers on how to incorporate into Lidocaine or Ketamine into clinical practice

Opioid Use Reduction Initiative chart 1

Opioid Use Reduction Initiative chart 2

Opioid Use Reduction Initiative chart 3