Tackling the Opioid Epidemic in Maine

The opioid epidemic doesn’t discriminate. This tragic and largely avoidable public health issue affects individuals from across the socio-economic spectrum, as well as people who worship various religions and those from a multitude of ethnic backgrounds.

The good news is that each one of us can take an active role in reducing the likelihood of more prescription painkillers ending up in the hands of someone who may at some point misuse these legal substances.

We can use National Prescription Drug Take Back Day on October 24, 2020, as a kickoff to help decrease the prevalence of this epidemic.

Let’s first get a refresh on the current situation.

Prescription Drugs: The Problem

Prescription drugs and painkillers – many times obtained legally and for legitimate usage – have unintentionally exacerbated the problem of addiction and drug overdoses in the opioid epidemic. The National Institute on Drug Abuse shares some poignant national statistics:

  • 67,367 drug overdose deaths reported in the U.S. in 2018, which was a decrease of 4.1% compared to 2017.
  • Opioids were involved in 46,802 (a rate of 14.6) overdose deaths in 2018, accounting for approximately 70% of all overdose deaths.

The opioid epidemic currently affects all 50 states, and Maine is no exception. Also according to the National Institute on Drug Abuse:

  • In Maine, 202 drug overdose deaths involved opioids in 2018, which is a rate of 23.4 and a decrease from the 360 deaths (a rate of 29.9) reported in 2017.
  • In 2018, Maine providers wrote 48.1 opioid prescriptions for every 100 persons compared to the average U.S. rate of 51.4 prescriptions.

While any improvement is encouraging, the State of Maine’s Office of the Attorney General (OAG) and the Office of Chief Medical Examiner reported in July 2020 that the COVID-19 pandemic has played a role in increasing the number of drug-related deaths this year as compared to the same period in 2019.

In many cases, the problem of addiction starts innocently. For example, a patient gets injured, and the subsequent surgery, and recovery, are acutely painful. The treating providers appropriately prescribe pain pills – many times opioids – to dull the pain. The patient gets hooked. In other cases, the patient simply stores the painkillers in the medicine cabinet “just in case,” but then the patient’s spouse or child takes the leftover pills and that triggers an addiction. No one thinks it will happen to them or their family, but this scenario unfortunately occurs all too frequently.

Prescription Drugs: The Solutions

Spectrum Healthcare Partners Standardizing Opioid Prescribing Practices in Orthopaedic Surgery in Maine

In an effort to reduce the number of prescription painkillers circulating throughout the state, Spectrum Healthcare Partners is leading several initiatives to help reduce the opioid epidemic in the state and has developed a unique program to control supply on the front end.

Spectrum’s orthopaedic surgeons and physician leadership has also been working diligently with Spectrum’s Quality Department to research prescribing practices for elective orthopaedic surgeries in Maine and learn how standard practices may be contributing to the opioid crisis. One interesting observation of the study included how a desire to satisfy patients and manage pain can lead to excessive prescribing practices. The research further suggests that standardizing prescribing practices for orthopaedic surgeries can reduce the number of opioids that are left unused by patients and therefore available for unlawful consumption.

To support the goal of standardizing prescribing practices, Spectrum has developed a proprietary decision-making tool. By reviewing Spectrum’s Ortho Pre-Op Prescribing Guidelines, orthopaedic surgeons in Maine can more accurately prescribe an appropriate number of pills for an injury or surgery with a prespecified level of pain, in general. For example, hand soft tissue procedures to treat a trigger finger would generally call for three pills due to the level of pain or discomfort. A more painful procedure such as ankle surgery to fix a multiple fracture may indicate the necessity of 15 pills to lessen the pain. It’s innovative programs such as this by responsible provider organizations that can help to reduce the number of drugs available for misuse.

Drug Take Back Programs

In addition to our internal initiatives, we are also pleased to support local and statewide drug take back programs.

The U.S. Drug Enforcement Administration (DEA) hosts National Prescription Drug Take Back Days twice a year, generally in April and October, and this fall the date is October 24, 2020.

The federal program dovetails nicely with Maine’s own Drug Take Back Program, an initiative that supports the responsible disposal of unneeded or unwanted medications.

What’s our goal? Encouraging Mainers to drop off leftover prescription drugs at one of many drug take back locations in our state.

Prescriptions that contain narcotics can often be taken to your local police department—contact them to learn relevant details, especially this year. Also, some pharmacies will take unused prescriptions, although be sure to ask in advance.

What Kinds of Drugs Can I Take Back?

That’s a common question that we hear, and it’s an important one to understand before emptying your medicine cabinet. Here’s what the State of Maine’s Office of Behavioral Health and Maine Center for Disease Control & Prevention share about items you can return, or not return.

Thermometers, infectious waste, hydrogen peroxide and beauty products and other items that aren’t allowed as a part of Maine’s Drug Take Back program can likely be handled by the Maine Environmental Depot in Lewiston, Maine. Ask your local police department to learn how to best dispose of controlled substances.What Should I Do About the Items I Can’t Take Back?

What NOT to Do with Unwanted Prescription Drugs

While it’s important to understand how to responsibly dispose of unused prescription drugs, it’s equally as important to know what not to do:

  • Don’t flush drugs. Flushing drugs or pouring them down the sink drain introduces prescription and other drugs into Maine’s water supply.
  • Don’t throw drugs in a garbage can. Simply throwing drugs away – either at home, at work or in a public receptacle – increases the chances that the vial can be found and the drugs used in appropriately. We need to be sure the pills are gone for good.

We Can All Do Our Part

All of us can play a small role in helping to reduce the number of overdose deaths in Maine. If you have questions about how to control your pain, please ask your orthopedic surgeon at Spectrum Orthopaedics, your provider at the orthopaedic walk-in clinic OrthoAccess or any other providers at Spectrum Healthcare Partners.

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