Alternatives to Opioids

Trinity Health of Livonia, MI, and Pacira Pharmaceuticals are joining forces to develop and standardize evidence-based strategies that would minimize opioid use.

The initiative, including protocols and education about alternatives to opioids, as well as appropriate opioid prescribing, will be implemented across Trinity’s 22-state health system.

Among the goals of the initiative:

• Identify patient populations that would benefit from strategies to minimize opioid use in hospitals

• Develop unique pain management protocols for specific conditions, injuries and surgeries.

• Reduce or replace opioids that are commonly used to manage postoperative pain

Paul Conlon, PharmD, Senior Vice President of Clinical Quality and Patient Safety for Trinity Health, said Trinity Health is committed to educating people about alternatives that can reduce the risk-and dangers-of addiction in the communities it serves.  

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Trinity Health and Pacira will develop and evaluate treatment programs aimed at reducing patient reliance on opioids and unnecessary exposure to narcotics. These programs, Conlon said, will include protocols and education about alternatives to opioids and about appropriate opioid prescribing for physicians.  

“It’s a perfect match. We are both committed to transforming the health of individuals and communities by improving patient care and reducing opioid reliance.” 

Role of the pharmacist

Conlon said that Trinity has a pharmacist-led opioid reduction program for postoperative pain.

“Pharmacists play a critical role in helping because they have access to medication histories, and can check databases when there is a suspicion that someone may have a substance abuse history,” said Conlon.

“Not all patients are forthcoming with their histories. The pharmacist is a good medication historian,” said Conlon. Pharmacists can make sure to get contracts for use of narcotics for some of those patients in chronic pain.

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He pointed out that pharmacists have a role in educating other clinicians, and that there’s a need for educating the clinical staff about the potential of opioid addiction and which drugs are more likely to have addiction potential.

“We believe that there is a great opportunity for pharmacists to be educators on this issue.”

A pharmacist-led opioid exit plan 

An article in the Journal of the American Pharmacists Association, Opioid exit plan: A pharmacist’s role in managing acute postoperative pain, found that “[A] hospital pain management team operating a pharmacist-led opioid exit plan (OEP) can be key to guiding the appropriate prescribing practice of opioids and assisting with transitions of care on discharge.” Genord and coauthors see OEP as a tool that has the potential to “expand the role of pharmacists in managing acute pain in postoperative patients.”

Benefits include:

• Medication reconciliation review

• Prescription drug-monitoring program search before admission

• Interdisciplinary rounds with medical team to provide inpatient pain management