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The MetroHealth System Slashes Opioid Prescribing by 3 Million

Opens Pain and Healing Center as alternative to pain management


MetroHealth doctors and nurse practitioners prescribed 3 million fewer opioid pills in the past 18 months, a reduction the health system believes to be one of the highest in the nation. Specifically, MetroHealth providers reduced the number of opioid pills prescribed by 62 percent for acute pain, and 25 percent for chronic pain.

To support patients who are in pain, the health system has also opened a Pain & Healing Center to provide alternatives to the addictive medication that kills, on average, 115 Americans every day.

“We’ve been tackling the opioid epidemic for a long time. Not until recently, did we recognize that providers can do a lot more,” said Akram Boutros, MD, FACHE, president and CEO of MetroHealth. “We want to be an example. We want to do better and start fixing the problem. If everyone followed our example, we would reduce the number of opioids prescribed in the United States by 4 billion pills annually, in the next 18 months.”

The reduction was achieved through MetroHealth’s electronic medical record system, which now alerts prescribers to patients who may be at risk of addiction, guiding them toward alternative medications, lower dosages and other options for treatment. The electronic medical record also offers to add a Naloxone prescription when prescribing opioids, an alert that has led to a 5,000 percent increase in Naloxone prescribing in the past three months.

In addition, every provider in the health system licensed to prescribe narcotics has undergone training to learn new ways for treating patients with chronic or acute pain. All providers attended mandatory town hall meetings to identify processes and tools for safe opioid prescribing, and to learn how to integrate tools to lower drug misuse while promoting effective patient adherence to drug regimens.

A safe opioid prescribing simulation program was developed for providers to practice crucial conversations with patients who may be seeking opioids. In these simulations, providers learned how to address difficult behaviors and illicit drug use and manage patients already on high-dose opioids. In addition, providers were educated about alternative options for pain management, including non-opioid medication or other therapies.

MetroHealth has opened a Pain & Healing Center, created to reduce opioid prescriptions and offer patients safe and effective alternatives for pain management.

The Center brings together many different therapies and specialists to help patients handle their pain without the use of opioids. Acupuncture, infusion therapy, reiki, pain management, neurology, psychology and psychiatry are among the therapies and specialty services offered.

“It was important for MetroHealth to step up and reduce the stream of opioids into the community, while also offering our patients pain relief through other measures,” said Dr. Boutros. “Patients welcome the ability to have non-opioid options available.”

These initiatives are all part of MetroHealth’s Office of Opioid Safety, which opened in 2017. Its mission is to promote opioid safety throughout the health system and in the greater community through education, advocacy and treatment.

About the MetroHealth System

The MetroHealth System, Cuyahoga County’s public health system, is honoring its commitment to create a healthier community by building a new hospital on its main campus in Cleveland. The building, and the 25 acres of green space around it, are catalyzing the revitalization of MetroHealth’s West Side neighborhood.

MetroHealth will break ground on the new hospital in late 2018, using nearly $1 billion it borrowed on its own credit after dramatically improving its finances. In the past five years, MetroHealth’s operating revenue has increased by 44.5 percent and its number of employees by 21 percent. Today, its staff of 7,700 provides care at MetroHealth’s four hospitals, four emergency departments and more than 20 health centers and 40 additional sites throughout Cuyahoga County. In the past year, MetroHealth has served 300,000 patients at more than 1.4 million visits in its hospitals and health centers, 75 percent of whom are uninsured or covered by Medicare or Medicaid.

The health system is home to Cuyahoga County’s most experienced Level I Adult Trauma Center, verified since 1992, and the only adult and pediatric burn center in the state of Ohio.

As an academic medical center, MetroHealth is committed to teaching and research. Each active staff physician holds a faculty appointment at Case Western Reserve University School of Medicine and its main campus hospital houses a Cleveland Metropolitan School District high school of science and health.

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