It was in the late-1990s when the opioid crisis was first mentioned in the United States as a challenge facing the healthcare system. Since then, our industry has faced multiple waves of the same crisis, when the main driver of the crisis shifted from natural opioids to semi- and now synthetic opioids.
Over two decades later, we are still facing the same dilemma but in a larger magnitude. Multiple federal agencies have been tasked to join forces and combat the epidemic from multiple angles. States have adopted new laws and regulations to limit access and provide treatment for patients with opioid addiction.
Compliance professionals have not been spared, and each has taken part in many ways in this matter, from partnering in drug diversion programs to implementing organizational policies and procedures. Many steps taken are retrospective reviews, yet the most impact would obviously come from proactive steps practically available to compliance professionals.
This article aims to provide some practical tools for compliance professionals in the healthcare industry, enabling them to effectively partner with other departments in this fight against the opioid epidemic in the US.
The start and current situation of the crisis
The first wave of opioid overdose deaths began in 1999 with increased prescribed opioids. Generally, there are three major categories of opioids: (1) natural opioids such as morphine and codeine, and semi-synthetic ones like hydrocodone and oxymorphone. This caused the first wave back in the ‘90s; (2) synthetic opioids such as methadone and fentanyl caused the second wave; and (3) heroin—an illicit, illegally synthesized opioid—caused the third wave alongside fentanyl.
The Centers for Disease Control and Prevention reported more than 932,000 deaths due to opioid overdoses between 1999 and 2020.[1] While in the early years of the 21st century, the most reported opioid overdose deaths were attributed to the prescribed natural and semi-synthetic opioids, the trend has shifted towards synthetic opioids since 2013.
In 2020, 91,799 drug overdose deaths occurred in the US. The number significantly increased in 2021 and reached 106,699 deaths from drug overdoses.[2] According to the latest release, the number soared to 107,477 in the 12-month period ending August 2022.[3]
A survey conducted in 2021 showed that an estimated 3% of survey respondents who were 18 years or older reported misusing opioids.[4]
When it comes to combating the opioid crisis, compliance professionals can play a vital role in cracking down the opioid-related frauds or misconduct, as well as taking a proactive position in educating healthcare professionals on applicable laws and regulations and enforcing policies and procedures.
This article presents the author’s professional experience as a compliance officer in a healthcare system around this topic.
When considering a compliance plan to combat the opioid crisis, both proactive and retrospective measures should be considered depending on available resources.
