New Connecticut Partnership Aims to ‘Make a Difference’ in Opioid Crisis

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HARTFORD – Amid the COVID-19 pandemic, Connecticut still grapples with another public health crisis: 1,273 people in the state died of opioid-related overdoses last year, up 13 % compared to 2019.

The Hartford, one of the nation’s largest providers of workers’ compensation and disability insurance, and the Yale School of Medicine want to help lighten that toll with a new partnership. The institutions announced an initiative focused on improving the training of healthcare professionals who treat one of the groups most vulnerable to opioid dependence and addiction: injured workers, who are prescribed often strong medications to manage their pain.

“Addiction and mental health have only worsened over the past two years with the COVID situation,” Hartford CEO and Chairman Christopher Swift said in an interview. “We are launching this pilot to see if we can make a difference. “

The Hartford donated $ 150,000 to support the pilot project run by the Yale Program in Addiction Medicine. The first phase includes the development of training modules and a collection of “clinically relevant” resources. In a second phase, which will run from January to June, training will be delivered to a preliminary group of 50 to 100 Connecticut healthcare professionals, who treat workers with acute pain, chronic pain and / or a disorder. related to substance use. In the final phase which is expected to take place in the third quarter of 2022, the modules will be updated based on feedback from medical providers.

Dr David Fiellin, Director of the Addiction Medicine Program, and Dr Jeanette Tetrault, Associate Director of the Education and Training Program, are leading the pilot project.

“When we realized that The Hartford was interested in this area, we were very excited to think of ways to use and apply the work we have developed over the past 20-30 years. in a new place, the workplace, ”Fiellin said in an interview. “It is common for both acute pain and chronic pain to be observed in the workplace, and we need to be able, where possible, to improve functional status and to treat pain with drugs and medications. behavioral treatments, avoid trajectories that lead to patients developing addiction, and address the stigma associated with these conditions.

Recent data show the prevalence of stigma towards people with drug addiction. According to a new study released by the Norwalk-based nonprofit Shatterproof, with support from The Hartford, 65% of healthcare workers said substance use disorders were not a problem. chronic disease.

Fiellin described the study’s finding as “shocking, but not surprising.”

“We know that nationally, only 30% of patients who are prescribed opioids receive what is known as prescribed care – care based on consensus and evidence to maximize benefit and avoid harm. risks, ”Fiellin said. “I don’t think injured workers are any different as long as there are opportunities, from a system perspective, to improve care processes and avoid addiction when possible. “

As the pilot focuses on Connecticut, officials at The Hartford, Yale and Shatterproof said the information from the program could potentially be applied nationwide.

Further advances in pain management and drug treatment are needed as the opioid epidemic continues to devastate the country. Estimated overdose deaths from opioids increased from 50,963 in 2019 to 69,710 in 2020, according to the Centers for Disease Control and Prevention.

“There is a clear need on the ground for this type of training,” said Matthew Stefanko, vice president of the National Stigma Index at Shatterproof, in an interview. “Assuming the results are as good as I think they will be, this could be the national model for improving addiction care and providing compassionate training that tackles stigma and delivers better outcomes for people. people with substance use disorders. “

The Hartford was a founding partner of the National Stigma Index, which was founded in 2019.

Several elected officials also praised the partnership.

“The Hartford and Yale School of Medicine have created a groundbreaking collaboration that will improve the lives of many and resolve a crisis that has devastated the state of Connecticut,” said U.S. Representative Jahana Hayes, D-Connecticut, who has spoke in June. To Virtual conference sponsored by The Hartford with a focus on mental health and addiction, said in a statement. “I am delighted to see community leaders working together to help tackle substance use disorders, from the lenses of prevention training at higher education institutions to response approaches on the ground. This partnership will benefit the community, students, faculty and healthcare providers for years to come. “

Senator Richard Blumenthal, D-Connecticut, said in a statement that The Hartford and the Yale School of Medicine “are leading the way in providing innovative, internationally recognized training to help curb the opioid epidemic, which has a corrosive grip. on communities here in Connecticut and across the country, ”

Work in progress to face the crisis

Hartford’s longstanding interest in tackling the opioid crisis reflects its status as one of the largest providers of workers’ compensation. In 2020, the No.142 company on this year’s Fortune 500 list recorded roughly $ 3 billion in workers’ compensation premiums, according to data from S&P Global Market Intelligence. Its market share of almost 6% ranks No. 2, after Travelers, among insurers issuing workers’ compensation in the United States.

The Hartford pays for treatment for substance use disorders if the condition is linked to the injury in a workers’ compensation claim, according to company officials. For example, if a construction worker were to sustain a back injury on a job site and medications prescribed to treat the pain resulting from the injury later lead to overuse, the company would consider treatment.

“We’re… a very interested viewer to kind of say, ‘What’s really going on here? “Because obviously we pay the bills,” Swift said.

Although the stigma of drug addiction persists, numerous initiatives across the country in recent years have increased health care providers’ understanding of the risk of prescription opioid addiction. Reflecting these efforts, opioid prescribing rates have declined dramatically in recent years.

“This is a very complicated scenario that often plays out between clinician and patient. We support shared decision making on these issues, ”Fiellin said. “Our goal is to enable effective treatment – whether it is opioids or behavior (treatment) or a combination – and improve patient function.”

The torrent of litigation sparked by the opioid crisis has also raised public awareness of the dangers of over-prescription and abuse of painkillers. Stamford-based Purdue Pharma, the maker of OxyContin, filed for bankruptcy in September 2019 after local and state governments filed several thousand lawsuits alleging the company fueled the outbreak with deceptive marketing of OxyContin, its best-selling product.

Although he denied the allegations, Purdue sought over the next two years to get a bankruptcy judge’s approval of his settlement plan. It got that approval in September, but Connecticut is one of the few states to appeal the approval.

“We cannot allow our bankruptcy laws to be abused and misused as a loophole for the rich and powerful to avoid justice and accountability,” the Connecticut attorney general said last month, William Tong. “When I talk to parents who have lost their children, to people who will spend the rest of their lives battling drug addiction, they don’t tell me to settle down. They tell me to keep fighting for justice, and that’s what I promised to do.

[email protected]; twitter: @paulschott


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