Striking a Balance: Safety-Net Leaders Explore Solutions to the Prescription Painkiller Epidemic

By Kristene Cristobal, Cristobal Consulting

Clinics and health plans serving low-income populations face a tremendous challenge — how to provide compassionate care for patients dependent on high-dose opioids, in the face of a growing epidemic of narcotic addiction and overdose deaths.

CHCF’s California Improvement Network (CIN), a community of organizations engaged in improving health care delivery, convened leaders from health plans, community clinics, and government agencies to come up with a menu of approaches appropriate for California clinics and Medi-Cal health plans.

The group talked about the current challenges facing providers caring for patients on high-dose opioids and promising models for treatment. They converged on a set of recommended approaches:

Meeting participant takes notes on butcher paper during small group discussion.
  • Create broad community coalitions
  • Build a culture of safe prescribing by establishing consistent clinical and operational practices
  • Offer providers training programs and resources
  • Create multidisciplinary teams to work with patients on high-dose opioids or those with complex conditions
  • Spread medication-assisted addiction treatment options
  • Deploy utilization and reporting tools to support safer prescribing
  • Explore payment reform to support integrated care
  • Develop and report outcome measures

This report describes the topics discussed over the course of the day: the problem of high-dose opioid use, the challenges involved in changing prescribing practices, and promising models that could be piloted and spread in organizations caring for low-income populations.

The complete report is available below.