Preventing Opioid Overdoses and Death: Let’s Start in the Hospitals

Michael Wong
Apr 12, 2019 · 3 min read

Co-written by Michael Wong, JD, with Arielle Bernstein Pinsof, MPP, Finn Partners and Gil Bashe, Managing Partner, Finn Partners Health Practice

Image for post
Image for post
In the clinical setting, overdoses are preventable as the full range of interventions is at hand.

The tragedy of our national opioid epidemic has gripped hearts and headlines for months now with heartbreaking personal stories, images and statistics. But the truth is, not all overdose deaths are taking place on the streets — so while physicians and lawmakers race to find interventions that work on the front lines in our communities, shouldn’t we also take concrete steps to reduce opioid overdoses in the clinical setting — where they are highly preventable — where the full range of interventions are at hand?

According to the National Institutes of Health (January 2019), more than 130 people in the United States die after overdosing on opioids every day. Among these deaths are patients in the hospital setting, recovering from surgical procedures or undergoing sedation, who are often prescribed opioids such as morphine and oxycodone to manage pain — a necessity for healthy and comfortable recovery. But at certain doses, these drugs can also cause respiratory failure, and, because each patient is different, there is no one dose that is “right” or “wrong.”

That’s where patient monitoring takes on an essential life-or-death function.

According to the Association for the Advancement of Medical Instrumentation (AAMI) Foundation, 50 percent of medication deaths are attributable to opioids and each year more than 20,000 patients administered opioids experience respiratory depression arrests — costing the U.S. healthcare system $2 billion each year.

Hospitals must take action to ensure their staff are aware of these risks, and to put protocols in place to prevent the unthinkable.

  • Periodic checks are not enough. Current monitoring procedures, which consist of periodic in-person checks by nurses and doctors on duty, can leave patients un-monitored up to 96 percent of the time. However, since opioid-induced respiratory depression can occur in a matter of minutes, relying on periodic checks is woefully insufficient.

Undeniably, our health system is overburdened. Clinical staff face shortages and burnout; new technologies entail capital as well as training costs; and changing habits or protocols is a massive undertaking. But to prevent unnecessary deaths due to opioid overdoses, we must change our approach to patient monitoring in the acute clinical setting. The current approach to this epidemic — policing, incarcerating and policy hand-wringing — has demonstrated some benefits, but will it be enough to help overcome this disease?

Enabling our hospital system to treat opioid overdoses requires a medical mindset. We should equip our frontline staff with the best medical guidelines, technologies and Federal and state policy support possible. Technology and training to overcome the opioid epidemic is a demonstrated path to success. It’s time to become far more innovative and take action.

Welcome to a place where words matter. On Medium, smart voices and original ideas take center stage - with no ads in sight. Watch

Follow all the topics you care about, and we’ll deliver the best stories for you to your homepage and inbox. Explore

Get unlimited access to the best stories on Medium — and support writers while you’re at it. Just $5/month. Upgrade

Get the Medium app

A button that says 'Download on the App Store', and if clicked it will lead you to the iOS App store
A button that says 'Get it on, Google Play', and if clicked it will lead you to the Google Play store