University Hospital announced on Wednesday that its S.T.O.M.P. program successfully reduced emergency department opioid prescriptions for discharged patients by nearly 70 percent since 2016.

The program, which stands for  Stewardship to Transform OUD while Medicating for Pain, was developed at Newark’s University Hospital as a hospital-wide opioid stewardship program to directly address the prevention and treatment of Opioid Use Disorder (OUD).

University Hospital said that the S.T.O.M.P. program achieved this significant reduction by developing and implementing policies over the past two years that use non-opioid medication in all instances where it is a viable option. Notably, this reduction has also been achieved without impacting patients’ pain management satisfaction scores or return rates for additional care.

Elnahal – NEW JERSEY DEPARTMENT OF HEALTH

“In partnership with Rutgers New Jersey Medical School, we are a Medicaid Center of Excellence for opioid treatment in New Jersey, and we place a lot of responsibility on ourselves to help lead the fight against the opioid epidemic,” said Dr. Shereef Elnahal, chief executive officer and president of University Hospital. “I am proud to share the work that care teams have done here in curbing the reliance on prescribing opioids for pain management treatment. We also continue to improve the services and treatments we provide to those who are currently struggling with opioid addiction.”

S.T.O.M.P. is comprised of a number of coordinated strategies to ensure responsible stewardship of opioids within the hospital:

• Adopting emergency department guidelines that reduce the reliance on opioid use through the use of non-opioid therapies;
• Implementing a strict hospital-wide stewardship program that emphasizes the use of non-opioid alternatives;
• Reducing default opioid prescription pill counts;
• Distributing naloxone in the emergency department to patients and educating them on its use;
• Initiating buprenorphine (Suboxone) treatment in the emergency department and throughout the institution, to prevent and treat opioid withdrawal;
• Adopting a warm handoff process, to link patients suffering from addiction with immediate counseling and treatment; and
• Introducing peer navigators in the emergency department.

“The best way to prevent opioid addiction is to not expose someone to a situation where addiction can develop, and our non-opioid pain medication management strategies allows us to just do that,” said Dr. Lewis Nelson, chair of the department of emergency medicine and chief of service. “In the instances where an opioid medication is absolutely necessary, usually in cases of serious acute pain, we work with the patient to keep the dose and duration as limited as possible, because long-term use is the leading cause of addiction.”

Nelson works closely with groups such as the Partnership for a Drug-Free New Jersey to educate health care providers and the public about the proper use of opioid medications and treatments.

For patients who are already struggling with opioid addiction or have just started down the path of recovery, University Hospital’s Departments of Emergency Medicine and Psychiatry jointly collaborate on initiating appropriate addiction treatment and prescribing harm reduction medication, such as naloxone, for individuals at risk of overdose. The warm handoff process provides hospital navigators and peer counselors to help steward patients through the health care system –like, attending clinics for subsequent appointments and calling patients for follow ups as they work through the recovery process – once they are discharged.