McKinney’s major hospitals for adult patients—Medical City McKinney, Methodist McKinney and Baylor Scott & White Health—are all acting to address the opioid epidemic, which the Centers for Disease Control and Prevention have classified as a national health crisis.
Opioid prescriptions have been reduced by 21% in the emergency rooms of Medical City Healthcare’s North Texas hospitals since the institution launched its Crush the Crisis initiative in November 2018.
“They’re a class of drugs that are exceedingly effective but also very, very addictive,” Medical City McKinney CEO Ernest C. Lynch III said.
Hospitals across the state are addressing the opioid epidemic through similar initiatives, said Karen Kendrick, vice president of clinical initiatives and quality at the Texas Hospital Association.
“Our hospitals are doing a great job of monitoring the types of medications they’re prescribing, using alternatives to opioid medications whenever possible and then giving only a limited prescription until patients can get to a primary care physician and be managed,” Kendrick said.
Fighting the crisis
In 2017, more than 70,000 people in the U.S. died from drug overdoses, and 68% of those overdoses involved opioids, according to CDC data.
Lynch said the opioid crisis does not discriminate based on demographics, age or wealth.
“Drug addiction cuts across all socioeconomic classes,” Lynch said. “There’s not a city or a county that’s not touched by it.”
Danny Andino, CEO of Arise Recovery Center, an outpatient addiction treatment center that has a location in McKinney, said his clinic provides resources for people who are trying to free themselves from addiction and are unsure where to turn.
“Some people, they start with a prescription, and they start to get that feeling that they really crave, and so they continue to seek more pills,” he said. “Sometimes, what we see is when they run out of those pills or the doctors aren’t giving them to [patients] anymore, sometimes, they’ll turn to heroin, which seems really crazy and unfortunate, but that’s the cycle that we see can happen as well.”
Local hospitals are addressing the opioid crisis with system-wide initiatives.
In the Medical City system, the opioid initiative is three-pronged. The first phase, which launched last year, focuses on lessening the number of opioid medications prescribed in Medical City emergency rooms. The final two phases, which focus on reducing the use of opioids in surgical recovery and on educating the community, respectively, were launched in September.
Dr. Jaya Kumar, chief medical officer at Medical City McKinney, said she and her colleagues focus on treating patients with equally effective, less addictive alternatives to opioids as much as possible. This includes using two or more methods of medications to manage a patient’s pain while they are recovering from surgery or being treated in the emergency room.
“As physicians, we’ve had a paradigm shift in the way we look at management of pain and, in general, pain control,” she said. Baylor Scott & White Medical Center-McKinney is also using this approach to manage pain. In addition, the hospital is now assigning a single healthcare provider to each patient to lead the course of the patient’s care and monitor pain management. And with the hospital’s use of minimally invasive surgery, recovery times are shorter and create less discomfort, Dr. William Montgomery, an orthopedic surgeon with Baylor Scott and White Medical Center-McKinney, and Dr. Laurie Novosad, a colorectal surgeon at the hospital, said in an email.
“This allows us to prescribe less opioid medication to patients and get them back to their normal life sooner,” the email stated.
Methodist McKinney Hospital, meanwhile, is prioritizing pain assessment and management.
“We have dedicated a multidisciplinary team to promote education and change in order to improve practices surrounding how we partner with patients to manage their pain in the safest way possible,” Joe Minissale, president of Methodist McKinney Hospital, said in a statement.
As part of its Crush the Crisis initiative, Medical City Healthcare is introducing new pain management strategies in its facilities. Kumar said these alternatives to prescribed drugs for post-surgery patients include distraction techniques, such as hot and cold therapy and massage therapy.
While reducing prescription rates is a step hospitals can take to reduce initial addiction, Lynch noted that illegal opioids also pose a serious problem.
“Illicit and re-manufactured fentanyl could be 50-100 times more potent than morphine,” Lynch said. “You also have the illegal drug trade, and it is significant. It’s a crisis.”
The third phase of Medical City McKinney’s Crush the Crisis initiative focuses on educating the community about the dangers of opioids and stressing the importance of safely disposing of unwanted medication.
Drug take-back boxes were installed in 12 Medical City hospitals in September, including one at Medical City McKinney, to provide locations to safely and anonymously drop off prescription opioids and other unwanted or expired medications.
It is important to use safe medication disposal methods, Lynch said, because flushing medication down a toilet or a drain can create potential health and environmental hazards.
Kumar also encouraged patients to use the drop boxes because leaving prescription drugs lying around the house can inadvertently make the drugs accessible to people who are already addicted to them, she said.
“About half of the people who misuse opioids actually obtained them from stealing them from someone they know,” she said. “If you’re prescribed opioids, you have to be responsible enough to save them and return them back if you don’t need them.”
For people already struggling with opioid addiction, a list of local treatment resources can be found on the federal government’s Substance Abuse and Mental Health Administration website.
“The community should come together and view addiction as a chronic disorder and not just as a taboo on drug addiction,” Kumar said.
Editor's note: The original post has been edited to correct an error referencing Methodist McKinney Hospital.