Dr. John Greenwood. (Goldfinch Health photo)
A program underway in Iowa is using opioid settlement funds to provide opioid prevention toolkits for surgery patients as part of the “Billion Pill Pledge” that’s designed to cut the use of prescription painkillers.
Goldfinch Health is administering the program in conjunction with the Iowa Attorney General’s Office. Doctor John Greenwood co-founded the company and says their approach involves teaching how to cut opioid use. “Consultation, education of providers and hospitals, and those involved in really the prescriptions of the opioids on some of these better alternatives, and these better approaches to treating people and their pain around surgery so that we are not relying on opioids nearly as much,” he says.
The toolkits also contain what’s called an RX destroyer to deal with extra painkillers. “They’re actually able to have in their hands an ability to denature and destroy any leftover opioid pills, so we can safely dispose of them,” Greenwood says. The education includes what’s called “Enhanced Recovery”, to better prepare patients before surgery. Greenwood says that involves educating providers that the old notion you can’t eat or drink anything after midnight the night before your operation doesn’t fit. You can have a clear drink up to two hours prior to your operation.
“I want to be very clear, you cannot have, we don’t want to have food on your stomach. But a clear drink up to two hours prior gets through your stomach and leaves you with all of the benefits of electrolytes and carbs and water — but it doesn’t increase your risk of aspiration and any of those potential fallouts,” Greenwood says.
He says there’s also education on the proper timing of pain medication. “We’ve all heard the idea of get ahead of the pain stay ahead of the pain. Well, let’s take that thought to its natural conclusion,” he says. ” When does the pain start? Not when you wake up from your surgery after your surgery, it’s when your scalpel that scalpel hits your skin during the operation. So we’re educating providers on nonaddictive pain medications provided to the patient before the procedure even begins.”
The preparation before the surgery also helps patients use less medication after surgery. “And so when you come out of surgery, we’re encouraging staggering, alternating Tylenol and ibuprofen for most patients. And that has been that combination has been shown to be three times more effective at treating pain than drugs like Percocet,” Greenwood says. “So that’s how we’re able to treat pain better, with better timing with better a mixture and dramatically reduce the number of opioid pain medications that people needed.”
The Cherokee Regional Medical Center and Floyd Valley in Le Mars, Decatur County Hospital in Leon and the Regional Medical Center in Manchester are the first four hospitals to sign up. Greenwood says they will be rolling out more soon.