In Texas, the number of opioid addicts is escalating and will continue to grow, according to Gary Malone, M.D., an addiction psychiatry specialist and member of the medical staff at Texas Health Arlington Memorial Hospital.
“These drugs are being prescribed daily, they enter the country illegally through drug cartels or people can even order them online from China,” he said.
Developed originally to control pain in terminally ill patients, opioids create a euphoric high. However, it takes higher doses to reach that high each time the drug is used. Prescribed opiates should only be taken a few days, or the risk of addition escalates.
“Just taking two, 15-milligram doses of OxyContin twice daily doubles the risk of mortality,” said Glenn Hardesty, D.O., a member of the medical staff at Texas Health Plano.
“What people don’t realize is that opiates are so addictive that most people will die before they can receive treatment,” Dr. Malone said.
State and federal lawmakers have introduced legislation to prevent overprescribing these painkillers and to increase funding for treatment and monitoring programs. But for the millions of people already addicted to opiates, this support may come too late. Their best chance at survival is a nasal spray known as Narcan®, which can instantly reverse the effects of an overdose. The U.S. surgeon general issued an advisory urging Americans to have the drug on hand to help those who may need it.
“Even though first responders and ambulances carry Narcan, they often are too late,” Dr. Hardesty said. “We need to put this in the hands of everyone and advocate for its widespread distribution. At our wholly owned hospitals, we’ve issued a standing order for nurses to administer Narcan to overdose patients immediately.”
While Narcan gives addicts the opportunity to live another day and hopefully enter treatment, only about one in 10 people receive the help they need3. This is due to the high costs or a lack of insurance coverage4. The cost to treat patients suffering from opioid dependence is more than 450 percent higher than for ordinary patients5. Rehabilitation centers offer financing plans, but costs for a 30-day program can range from $6,000 to $20,000 – or much more6.
For those who can be treated, qualified recovery centers often are at capacity.
“The state of Texas does not currently have the resources to deal with this problem,” Dr. Malone said. “Those seeking help are put on wait lists.”
Texas Health is the largest provider of behavioral health services in North Texas. It offers access to comprehensive mental, psychiatric and behavioral health services in both inpatient and outpatient settings across the Dallas-Fort Worth area. The Texas Health Recovery & Wellness Center also helps patients who need long-term treatment and recovery.
Dr. Hardesty chairs an opioid workgroup that is identifying additional strategies the health system can take to reduce opioid-related deaths. One strategy is to change how often opiates are prescribed – and to whom.
“Responsible prescribing is one of the cornerstones of addressing the issue,” he said.
This entails identifying patients who are have been prescribed opiates so alternative therapies can be administered. Strategies also may include setting limits on the duration prescriptions can be taken and altering order sets so that non-narcotic painkillers are given first.
The workgroup also is assessing technologies that can help clinicians quickly access patients’ prescription histories as well as tools that can embed prescription guidelines into electronic health records. Workgroup members will share their recommendations with senior leadership and hope to start implementing measures very soon.
From working on the front lines within the emergency department to collaborating with community health agencies, addressing the opioid crisis is part of Texas Health’s Mission to improve the health of the people in the communities we serve. To learn more about this crisis, listen to our podcast.