Addiction to and overdose from opioids such as morphine, oxycodone and heroin have reached epidemic proportions in the United States — and Wisconsin. Over the past decade, opioid-related incidence of overdose and death in the state has increased more than 300 percent. Prescription opioids contribute to the vast majority of opioid-related complications, including overdose and death.
Victims of traumatic injury are at greater risk for misusing opioids than the general population. Therefore, appropriate assessment, prevention and intervention are needed for this high-risk group.
Screening in Trauma for Opioid Misuse Prevention (STOMP), a project funded by the Wisconsin Partnership Program, aims to address this need. Dr. Randall Brown of the University of Wisconsin School of Medicine and Public Health, principal investigator and associate professor in the Department of Family Medicine and Community Health, and his team of researchers are developing a screening tool to predict risk for opioid misuse and related complications after traumatic injury. They plan to pilot the implementation of the tool at University Hospital in Madison and four Wisconsin trauma centers.
The project will engage addiction experts and trauma center representatives to inform the initial development of the screening tool. They are collecting information about patient issues that could be predictive of addiction, such as:
- Past substance use
- Mental health issues
- Factors related to circumstances of injury (severe accident or assault)
- Physical or emotional trauma
The team is also studying other information including:
- The number procedures the patient had
- Severity of pain at time of discharge
- Patient’s social support network
- Post-discharge opioid use patterns
Brown says, “Right now we are collecting a great deal of information, and upon analysis, will select key information and formalize it into the screening.”
The researchers will also determine what type of screening is feasible to implement within trauma centers. Says Brown, “The screening tool must fit well within the workflow of the trauma center.”
Once the screening tool is developed, the team will pilot it at Level I and Level II Wisconsin trauma centers including University Hospital, Gundersen Health System, Marshfield Clinic Health System, Medical College of Wisconsin and ThedaCare. The trauma centers will provide feedback for further refinement of the tool based on its clinical implementation.
The project is expected to result in better screening and early intervention. “Ultimately, if we can learn how to identify and support people at risk for opioid misuse, we can reduce the risk of addiction, overdose and death and be one step closer to solving Wisconsin’s opioid crisis,” Brown says.