Ohio State tackles opioid crisis from multiple angles

Fighting the opioid epidemic in Ohio, which has the second-highest rate of opioid overdose deaths in the United States, is considered by many health practitioners at The Ohio State University not just a professional responsibility, but also a moral imperative.

That sense of obligation was a driving force behind the collaborative approach to Ohio State’s proposal for a HEALing Communities Study grant, said lead investigator Rebecca Jackson, director of Ohio State’s Center for Clinical and Translational Science and associate dean for clinical research in the College of Medicine.

With the $65.9 million federal research grant awarded in April, Ohio State is leading a consortium of academic, state and community partners that aims to reduce overdose deaths by 40 percent over three years. Ohio’s overdose death rate stands at 39.2 deaths per 100,000 people, compared to the national average rate of 14.6 deaths per 100,000 people.

The proposal centers around identifying data-driven, custom-designed response strategies to treat addiction. The coalition plans to implement evidence-based prevention and treatment interventions in a variety of settings, providing professionals on the front lines of the opioid crisis with real-time information about the most effective approaches.

“Rather than the traditional research top-down model where we drive intervention … this is truly a community-driven process in order to understand ways to more effectively address the opioid crisis,” said Jackson, presenting to the Ohio State University Wexner Medical Center Board of Trustees last week. “We think the lessons learned here will actually help reduce opioid use disorder and opioid use fatalities … across every state in the country and potentially the world.”

The federally funded study joins a long list of Ohio State prevention, treatment and support initiatives.

The College of Pharmacy has encouraged responsible use of prescription medications since before opioid misuse and overdose deaths emerged as a crisis. The college established the Generation Rx program in 2007, which to date has educated more than 2 million people about drug misuse prevention through a train-the-trainer structure.

Andrew Thomas, Wexner Medical Center’s chief medical officer, told the board about modified practices in prescribing medications, treating pain and supporting patients with addiction that show “the new seriousness and new focus our providers have taken on this issue over the last few years.”

Between 2015 and 2018, the medical center reduced the amount of opiates prescribed per discharged patient by 66 percent, and cut the percentage of patients discharged with opioid prescriptions by about 17 percent, even as admissions increased.

Thomas said Ohio State is a national leader in reducing opioid treatment for surgical patients through a program emphasizing pre-operative diet and exercise education and the use of non-opiate, non-addictive pain interventions during and after surgery. The program has reduced post-op opiate prescriptions between 27 percent and 60 percent across four specialties – with no drop in pain management patient satisfaction scores.

This approach extends to the Healthy State Alliance launched last fall by Wexner Medical Center and Mercy Health. Anderson Hospital in Cincinnati is poised to implement the program for orthopedic joint replacements, Thomas said.

Thomas also described a number of overdose prevention measures, which include drug treatment for inpatients who arrive with an opioid overuse disorder and sending naloxone nasal spray kits home with emergency patients. Pregnant patients who are addicted to opiates can access obstetric care and drug treatment in the same clinic setting.

On the research front, Ohio State health researchers are partnering with the Ohio Development Services Agency on a $5 million collaborative to explore innovative pain treatment techniques such as a topical non-opioid cream. But scholarship on the epidemic is not restricted to health disciplines.

Faculty from sociology, geography and political science are examining the “dark web” drug market, neighborhood factors behind addiction and citizen education on the crisis, respectively. They discussed their research at a March event highlighting differing approaches to addressing the opioid epidemic.

The university also centrally supports a wide range of research projects. Since 2017, the Opioid Innovation Fund created by Executive Vice President and Provost Bruce A. McPheron has distributed nearly $1 million to 16 projects serving one of two goals: to develop products that community partners can use right away or to answer research questions that inform the scientific community, practitioners and policymakers.