New Program to Address Opioid Crisis

Monday, September 11, 2017

CHICAGO – In response to the opioid crisis, Rush University Medical Center is developing a comprehensive program that will provide opioid screening and treatment for patients identified as opioid users on the medical and surgical inpatient units and will expand to outpatient screening. 

“The goal is to increase access to treatment and to reduce opioid and heroin overdose related deaths through prevention, treatment and recovery,” said Dr. Niranjan Karnik, a psychiatrist at Rush who will be overseeing the program.

Rush received a $380,000 grant from the Illinois Department of Human Services, Division of Alcoholism and Substance Abuse, in support of the new program. Funding is part of an Opioid State Targeted Response grant to the state of Illinois from the U.S. Department of Health and Human Services’ Substance Abuse and Mental Health Services Administration. The $16.3 million grant supports multiple prevention, treatment and recovery support services that are being implemented across the state to address the opioid crisis.

Deaths from opioids now exceed traffic fatalities

Opiates are a class of painkillers or analgesic drugs, including those naturally derived from opium such as morphine and heroin. The rapid increase in the use of prescription and non-prescription opioids in the U.S. and Canada in the 2010s is regarded as an epidemic of opioid abuse.

According to the Department of Human Services, drug overdose deaths in the United States nearly tripled from 1999 to 2014. Among the 47,055 drug overdose deaths that occurred in the U.S. in 2014, 28,647 (60.9 percent) involved an opioid.

Of the 2,278 Illinois statewide drug overdose deaths during 2016, more than 80 percent were opioid-related fatalities. The 1,826 opioid-related overdose deaths among Illinois residents that have been provisionally reported for 2016 represents a greater than70 percent increase in the number of such deaths that were reported in 2013, and a 32.1 percent increase over the 1,382 opioid-related overdose that were reported to IDPH for 2015.

“Deaths from opioid overdose now exceed the number caused by traffic accidents or gunshots in the U.S.,” Karnik said, noting that Chicago-area deaths from opioid overdoses rank among the nation’s highest.

“Such statistics illustrate the need for a critical discussion and evaluation of the use and misuse of opioids, prevention strategies, overdose treatment and long-term addiction care,” he said.

Program will include addiction counseling, training 

Rush will be launching a new comprehensive substance use consultation service. All patients admitted to Rush’s inpatient medical and surgical units will be screened by nursing staff and social workers. These providers will be able to call the new substance use intervention team to come to the bedside to work with patients through motivational interviewing and, when appropriate, initiate medical treatments. When necessary, these patients will be referred to outpatient treatment or residential treatment depending on the level of need.

Rush also will develop training programs for clinical staff, such as physician assistants and nurse practitioners, to identify addiction, prescribe the addiction treatment medication buprenorphine and use medical-assisted therapies for substance abuse more effectively. Rush also will be partnering with Midwestern University to provide training for pharmacy students who will engage in the inpatient intervention with the substance abuse intervention team.

Rush will also establish an addiction medicine fellowship using grant funds. It will provide advanced training in addiction medicine to physicians and nurse practitioners regardless of their disciplinary background. This will result in broadening access to care for substance use disorders and greater availability in primary care clinics.

In addition, Rush will bring the program to patients in the Medical Home Network, a collaboration of health care providers to enhance the delivery of care. The Medical Home Network includes Rush, five other hospitals and more than 100 clinics and physician practices in the Chicago area.

“Every day, hospitals across Illinois experience the devastating effects of this country’s opioid crisis. The Opioid STR grant-supported program that is being implemented by Rush is an example of the multiple hospital-based strategies that can be effective in fighting this multifaceted and serious public health problem,” said Dr. Maria C. Bruni, acting director of the Illinois Department of Human Services, Division of Alcoholism and Substance Abuse.