51社区

While the world鈥檚 attention to public health remains focused on COVID-19, Berkeley Franz, Ph.D., assistant professor at the 51社区 Heritage College of Osteopathic Medicine, continues to focus her attention on one of the largest public health crises in the United States today 鈥� the opioid epidemic.

Franz, along with Cory Cronin, Ph.D., assistant professor in OHIO鈥檚 College of Health Sciences and Professions, and Jos茅 Pag谩n, Ph.D., professor of public health policy and management at New York University,  co-authored the article, 鈥�," to identify what hospitals are doing to combat the opioid epidemic and how they could better address these problems in communities.

The study led by Franz is published in Public Health Reports, the official journal of the Office of the U.S. Surgeon General and the U.S. Public Health Service.

鈥淧rior to the COVID-19 pandemic, the opioid epidemic was the most vexing health problem,鈥� Franz said. 鈥淗igh rates of addiction were cited as one of the main reasons that American life expectancy declined in multiple years, something we rarely see. At the same time, opioid misuse increased to be the greatest causes of preventable death. This study shows that hospitals can play a clear and important role in implementing interventions and effectively treating patients, especially if they are willing to do so on site.鈥�

This study is part of ongoing research Franz is doing to understand whether hospitals are addressing the most critical public health needs in their communities.  She is also studying institutional barriers to adopting new programs to address opioid misuse, including the presence of bias/stigma among health care professionals. 

Through their research, Franz, Cronin and Pag谩n found that hospitals often don鈥檛 do evidence-based programs despite evidence that treating the patient at the hospital rather than through a referral leads to more effective treatment and reduces death from subsequent overdoses.

鈥淲ith opioid misuse, people often end up in hospitals for care, which is a great place to address other, secondary health consequences that come from the misuse,鈥� Franz explained. 鈥淎side from an actual overdose itself, people can get infections at the injection site, heart and skin infections, infectious diseases linked to intravenous drug use and more. By taking care of these individuals in a hospital setting, medical professionals can also address these issues as well as introduce treatment for the underlying substance use disorder.鈥�

To compile data, the researchers analyzed data from a 20% sample of all U.S. hospitals to determine what they were doing to address opioid abuse.

The researchers looked at whether hospitals offered specific kinds of services 鈥� and specifically whether the hospitals were directly addressing the issue or redirecting patients to primary care or other outpatient care.

鈥淲hile individual health needs assessments and implementation strategies are publicly available, our hope is that by aggregating strategies and trends, we can provide a snapshot of the overall picture, which may be helpful to decision makers in health care organizations or public agencies,鈥� Cronin said.

The study shows that nonprofit hospitals invest in clinical strategies and risk education, but they could do more by initiating medication-assisted treatment at the hospitals and adopting harm reduction initiatives, such as distributing naloxone or offering syringe exchanges.

鈥淲e have created a great partnership between 51社区 and New York University researchers interested in the contribution of hospitals to improve the health of our communities,鈥� Pag谩n said. 鈥淚 am very lucky to have had the opportunity to work with this great team and bring awareness to the important leadership role hospitals play in our communities to help reduce opioid abuse.鈥�

Pag谩n added that state support is important, as hospitals are more likely to adopt harm reduction programs and other strategies in states that take the lead encouraging the use of these strategies.

Although some hospitals are adopting evidence-based strategies to address opioid misuse, the pandemic is affecting how hospitals can implement such programs effectively. For instance, many hospitals are currently focused on fighting COVID 19, so they may have fewer opportunities to offer substance abuse services. At the same time, the added societal stress of the pandemic can actually exacerbate substance misuse. Also, some hospitals do not offer direct services for those who misuse substances.

Franz is also holder of the Heritage Career Development Faculty Endowed Fellowship in Population Health, Osteopathic Heritage Foundation Ralph S. Licklider, D.O., Research Endowment, which supported this research study through providing funding support to train/work with Jose A. Pag谩n and also provided direct funds for carrying out the research itself.