Grand Strand Health’s opioid reduction initiatives target surgeries, aims to eliminate ‘doctor shopping’

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MYRTLE BEACH, SC (WBTW) — Grand Strand Health’s opioid addiction prevention initiatives are seeing success.

Since the beginning of 2002, Grand Strand Health patients who chose to participate in an enhanced surgical recovery program shortened their hospital stays by more than five days and saw a complication rate of .84%, compared to 3.31% for people who didn’t participate in the program, according to Tammy Cox, the director of quality for Grand Strand Health.

The chance of being readmitted following surgery also decreased, from 11.4% who didn’t participate in the program, compared to 3.3% who did. 

The surgical recovery program is one step in the health system’s multi-pronged approach to prevent opioid addictions and lower deaths caused by drug overdoses.

“No one wakes up one morning and says, ‘I choose to be addicted to a drug,’” said George Helmrich, the chief medical officer of the Grand Strand Health system, which includes Grand Strand Medical Center in Myrtle Beach. 

Drug overdose deaths have been steadily climbing in South Carolina, with 1,131 deaths last year, according to information from death certificates registered with the South Carolina Department of Health and Environmental Control Vital Statistics. In 2019, 923 deaths included prescription drugs, 876 involved opioids, 537 involved fentanyl and 196 involved heroin. Deaths are counted by drugs in the individual’s system, which means that deaths can be counted in multiple categories depending on which substances the individual took. 

Heroin, fentanyl and prescription pain relievers are all opioids. 

Horry County, specifically, is considered a hot spot in the state for opioid overdose deaths. 

In July of 2018, HCA Healthcare — Grand Strand Health’s parent company — joined the National Academy of Medicine’s Action Collaborative on Countering the U.S. Opioid Epidemic. That same year, the health system launched its Crush the Crisis nationwide initiative, which has led to measures such as developing new pain strategies, offering alternatives to opioids and tracking prescriptions through an online system.

Since then, the system has seen an overall 36% decrease in patient opioid use. From Jan. 2018 to June 2019, it also saw that opioid use for major abdominal, joint, gynecology oncology, spinal and bariatric surgeries were cut in half for patients who participated in its enhanced surgical recovery program.

Helmrich said that starting in the 1990s, pain was considered the fifth vital sign and seen as something unnatural that should never be experienced. 

Since then, as awareness rose about the addictiveness and dangers of opioids spread, doctors have become more aware of what they’re prescribing. 

The system is trying to reduce the exposure to opioids as much as possible. It’s encouraging alternatives, such as lidocaine and ketamine, that do a similar job without bringing as many dangers.

The new surgical initiative includes measures such as giving patients a carbohydrate-heavy drink before they come in, using fewer drugs and slowing down the bowels during surgery in order to discharge patients earlier and prevent infections. 

Those proactive measures hope to curb addictions before they can begin. To help with that effort, and eliminate addictions that have already started, the system has also moved to digital prescribing. 

“The old days of stealing the paper pad from the doctor’s office to write prescriptions should be gone,” Helmrich said. 

It also seeks to cut down on “doctor shopping,” when patients will visit different physicians until they get the prescriptions they’re pursuing. 

Digital prescribing, Helmrich said, will let the system know if patients are abusing the system.

“At some point, the cycle needs to be broken,” he said. “It won’t break itself.”

Another preventative approach has been an annual drug takeback day. The event aims to prevent unused medications from being abused, whether by the original patient or by family members. 

This year’s event, held in October, gathered more than 123,400 individual doses of medication. At last year’s, Helmrich said one man brought in an entire mayonnaise jar filled with loose pills.

But eliminating opioid deaths, he said, will take help from the entire system.

“The physicians here are very conscious that it is a problem,” Helmrich said. “It isn’t just bad people, and the person needs to be treated as a whole person.”

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