Blog

By Daniel Stein

Even amid the coronavirus tragedy, another major public health emergency continues unabated: our country’s opioid epidemic. So we decided it was important to focus on that topic during last week’s regular NIC webinar/discussion with three officials of the Agency for Healthcare Research and Quality. AHRQ is a too-little-known federal agency that’s an important part of the Department of Health and Human Services.

A key message from the presenters holds lessons for the U.S. response to Covid-19 as well; that is, we need to effectively move evidence into practice in order to fully address the crisis. In the case of opioids, that means both dealing with the addiction part of the problem and finding other ways to manage pain.

The webinar was titled “Getting Evidence into Practice: Lessons from the Opioid Crisis,” and the three AHRQ presenters were Medical Officer Elisabeth Uphoff Kato, Staff Fellow Roland Gamache and Program Officer Suchitra Iyer. 400 attendees from health, healthcare, social services and other public and private sectors and systems attended – a record high for our weekly webinar series!

The stakes in learning the opioid epidemic’s lessons could hardly be higher. Indeed, the presenters agreed that if evidence had better-informed practice in the early days of that emergency, at least part of it could have been mitigated or avoided. They said that was because examining/analyzing all the opioid-related research and other evidence contributes to a more-accurate understanding of various treatments’ effectiveness and, more broadly, to better insights into the balance between harm and benefits.

In addition to hearing from our colleagues at AHRQ – whose mission is to improve the use of evidence – webinar attendees provided their own information and asked thoughtful questions, including:

• Remote physiologic monitoring can contribute to improved safety. For instance, this technology can warn providers, caregivers, emergency medical providers and the patients themselves if they are exhibiting signs of opioid-induced respiratory depression before it leads to overdose.
• There is embedded bias in the administration of pain medications. For instance, research shows that some doctors administer different treatments for black and white patients because of the mistaken belief that they feel pain differently.
• Systems seem too slow in reacting to patients’ needs. What’s the plan, an attendee asked, for providing genuinely patient-centered care that’s focused on health rather than pathology?
• The CDC 2016 guidelines and all the policy/practice changes that followed dismissed the benefits of opioids, based on an AHRQ 2014 review of evidence related to their use. Yet the number of prescriptions for opioids has not diminished.

One question that particularly resonated with webinar attendees was this: “As we look at the resources, methodologies and approaches that AHRQ is focused on now, what might be transferable or adaptable to the Human Services side as it relates to social factors and social determinants?” The presenters replied that AHRQ is currently conducting a number of projects related to the Social Determinants of Health and Well-Being (SDOH), including work with health and healthcare systems.

A National SDOH Action Agenda

We know there are clear linkages between SDOH and Opioid Use Disorder; the same is true between SDOH and Covid-19 -- which, for example, is taking a disproportionately higher toll on communities of color. To address these challenges and others as they relate to SDOH, NIC will be working with organizations such as the WIN Network, All-In, and many others across the country to develop a National Action Agenda for Advancing SDOH. We invite you to join us for this exciting, multi-domain, multi-discipline initiative, which we’ll be rolling out throughout this year and beyond.  

Our AHRQ colleagues shared several resources during their webinar last week, including:

• Noninvasive Nonpharmacological Treatment for Chronic Pain
• Opioid Treatments for Chronic Pain
• Nonopioid Pharmacologic Treatments for Chronic Pain
• Clinical Decision Support tools and components
• CDS Connect: Pain Management Summary

Join Opioid Prevention Group >>

Join SDOH Group >>

Please share your comments/questions in the comments section below, and/or by joining in our upcoming webinars.