In the United States, an opioid crisis of epidemic proportions blossoms. While the social and economic costs of the dire problem are topics of much concern, it is of equal merit to explore the impacts to hospitals. Such costs have implications that are far reaching and touch both the professional care providers and their patients. These ripples also bode ill for long-term health care goals and patients’ quality of care. Below, this article explores the numbers and unpacks the issue, addressing the problems of a system strained by a sharp increase in patients and the need for action.
Not a New Problem
This issue has been gathering steam for some time, but it took a sharp upward turn in recent years. Purdue Pharma billed its drug, OxyContin (controlled-release Oxycodone), as a non-addictive medication suitable for a range of palliative uses. Released in the late 90s, the company encouraged physicians to prescribe it to their patients, investing significant time and resources into this dialogue with the healthcare industry. According to an article published in the American Journal of Public Health (AJPH), in only four years, the sale of OxyContin rose from $48 million to over $1 billion. That was nearly two decades ago, as of this writing.
Since that time, those who fell prey to addiction did so primarily out of the public’s eye. Addiction is a taboo subject in American culture, and many have preconceived notions about the types of people who become addicted. But communities noticed. In many places, local action initiatives predate federal or regional aid by an embarrassing margin. These addicts are their respected members, their children, their friends and small business owners. But, until the long-term statistics began to sound the alarm, there was no sign that help was coming from higher levels of government.
The Statistics and Hospitals
That health care providers inadvertently fueled this epidemic, prescribing what they were assured was a safe method of pain management, is not the issue. Now, hospitals across the country are struggling to meet the needs of their communities, whoever is responsible. The Healthcare Cost and Utilization Project (HCUP) represents one of the most extensive longitudinal collections of healthcare cost data in the United States, and the picture they paint is alarming.
Their finished report states that between 2000 and 2014, the rate of deaths due to opioid overdose rose 200 percent. From 2005 to 2014, the rate of inpatient stays directly related to opioid use increased more than 64 percent and ER visits for overdose spiked nearly 100 percent. Even accounting for individuals with medical coverage who could pay in full for their treatment, this sharp uptick puts stress on the provider networks in all states. Associated materials and even physical space needs for treatment supply additional, often-overlooked consequences. An article in the Hospitalist points out that an increase in 911 calls for assistance also puts strains on resources and has economic repercussions that often go unaddressed.
Now that the problem has been unambiguously addressed, hospitalists and healthcare personnel are rolling up their sleeves and getting to work. Relying on a multi-faceted plan of attack, there’s hope that the opioid addiction epidemic can be curtailed and reversed, with help for those who need it in greater abundance. Doctors are more carefully screening for addictive behavior before prescribing opioids, offering alternative therapies or medications, strictly following a pain management plan with patients, and providing education to both family and community members. There is every hope that the country can move through these troubled times to healthier, drug-free days.
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