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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 is redefining health care by going beyond medical treatment to improve the foundations of community health and well-being: affordable housing, a cleaner environment, economic opportunity and access to fresh food, convenient transportation, legal help and other services. The system strives to become as good at preventing disease as it is at treating it.

The system’s more than 600 doctors, 1,700 nurses and 7,800 employees go to work each day with a mission of service, to their patients and to the community. As Cuyahoga County’s safety-net health system, MetroHealth plays an essential role in the region, caring for anyone and everyone, regardless of an ability to pay.

Founded in 1837, MetroHealth operates four hospitals, four emergency departments and more than 20 health centers and 40 additional sites throughout Cuyahoga County. The system serves more than 300,000 patients, two-thirds of whom are uninsured or covered by Medicare or Medicaid.

MetroHealth is home to Cuyahoga County’s most experienced Level I Adult Trauma Center, verified since 1992, and Ohio’s only adult and pediatric trauma and burn center.

As an academic medical center, MetroHealth is committed to research and to teaching and training tomorrow’s caregivers. Each active staff physician holds a faculty appointment at Case Western Reserve University School of Medicine. Its main campus hospital houses the Cleveland Metropolitan School District’s Lincoln-West School of Science & Health, the only high school in America located inside a hospital.

Knowing that good health is about much more than good medical care, MetroHealth has launched the Institute for H.O.P.E.™ (Health, Opportunity, Partnership, Empowerment), which uses a coordinated, collaborative and strategic approach to help patients with non-medical needs such as healthy food, stable housing and job training.

The MetroHealth Glick Center, a new 11-floor hospital, is under construction on the system’s main campus in Cleveland and is scheduled to welcome its first patients in October 2022. The billion-dollar project is the cornerstone of a wider neighborhood revitalization effort led by the system and its partners in the community.

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