Solving America’s Prescription Epidemic: Solutions, Current Practices, Provider Internal Skills, and Systems Approach to Care

Abstract

Solving America’s Prescription epidemic will be a team effort involving medical and pharmaceutical institutions, law enforcement, and community, state and federal governmental support programs. Within medical institutions, hospitalists need an understanding of the nation’s approach to prevention of opioid dependence, current practice management, provider internal skills that must be learned and a systems approach to care. A real case report serves to demonstrate important points in the management of these patients. A graphic demonstrates how patients get caught in a cycle of iatrogenic opioid dependence and how evidence-based methods for the treatment of chronic pain and addiction must be used to lead patients toward independence and self-management. The care pathway for the prevention of addiction is outlined in a graphic and discussed. The hospitalist role is reviewed along with other physician and provider roles to promote teamwork. Community and national strategies from the Institute of Healthcare Improvement outline current strategy that is unfolding to solve this crisis. The hospitalist role will be to coordinate care with other providers, make long-term treatment care plans, withdraw patients from opioids, and participate with system administrators to make the necessary healthcare system organizational changes.