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Michigan Opioid Prescribing Engagement Network (Michigan OPEN)

A three-pronged approach to reduce opioid-related harms in Michigan through prescriber recommendations, community education, and safe disposal of prescription opioids

Founded to develop a preventive approach to the opioid crisis through a focus on reducing acute care prescribing, Michigan Opioid Prescribing Engagement Network (Michigan OPEN) was launched in October 2016 by several physicians at the University of Michigan. The program recognizes that addressing opioid prescribing during the acute care period among those patients not using opioids has the greatest potential to reduce the number of new chronic opioid users and minimize unintended distribution of prescription opioids into communities. Michigan OPEN's three prong approach includes:

  • Prescriber recommendations - developed evidence-based opioid prescribing and counseling recommendations in the U.S. for 25 common surgeries. These recommendations are available online for free and are updated regularly 
  • Education - presented educational forums to thousands of surgeons, physicians, nurses, dentists and physician assistants across the U.S.
  • Medication disposal - developed patient educational materials on safe use, storage, and disposal of opioid medications and partners with communities, hospitals, and law enforcement agencies to hold prescription opioid recovery drives twice a year in locations throughout Michigan. One of their prescription drug take-back events has been evaluated showing impressive results. 

Michigan OPEN is a data-driven program that informs the development of prescribing recommendations for surgical procedures, disseminating feedback to providers, informing policy, developing education materials for patients and providers, implementing local quality improvement, and engaging partners in hosting medication take-back events in areas hardest hit by the opioid crisis.

More information on the program can be found in this presentation and in this video. 

Decrease in number of prescription opioids used with no clinically important changes in satisfaction or pain scores.

Continuum of Care
Prevention
Type of Evidence
Peer-reviewed
Response Approach
Cautious Opioid Prescribing
Educational
Peer-reviewed Article
Statewide Implementation of Postoperative Opioid Prescribing Guidelines
Assessment of a quality improvement intervention to decrease opioid prescribing in a regional health system
Related Resources
CDC Guideline for Prescribing Opioids for Chronic Pain — United States, 2016
Prescriber Education Interventions to Optimize Opioid Prescribing in Acute Care: A Systematic Review
Quality Improvement and Care Coordination: Implementing the CDC Guideline for Prescribing Opioids for Chronic Pain
CMS opioid prescribing tool - Medicare
Prescription Drug Monitoring Programs: Evidence-Based Practices to Optimize Prescriber Use
Prescription Drug Community Action Kit: Safe Medication Disposal Guide
Bending the Prescription Opioid Dosing and Mortality Curves: Impact of the Washington State Opioid Dosing Guideline
Managing Pain Safely: Tapering Toolkit for Providers
An Institutional Approach to Managing the Opioid Crisis
Veterans Affairs/Department of Defense Clinical Practice Guidelines
Removing Abuse-Prone Prescription Medication from Fueling the National Opioid Crisis Through Community Engagement and Surgeon Leadership: Results of a Local Drug Take-Back Event

Evidence of Program Effectiveness

"During the period after guideline release, the change in prescription size was −1.3 pills per month. This represented a significant difference in slope of −0.8 pills per month between the pre- and post-guideline periods. The mean prescription size decreased from 26±2 pills in the pre-guideline period to 18±3 pills after the guidelines were released. Opioid consumption also decreased from 12±1 to 9±2...despite the reductions in prescription size and opioid use, no clinically important changes in satisfaction or pain scores were observed." (Vu et al., 2019)

"The use of procedure-specific prescribing guidelines reduced statewide postoperative opioid prescribing by 50% while providing satisfactory pain care. These results demonstrate meaningful impact on opioid prescribing using evidence-based best practices and serve as an example of successful utilisation of a regional health collaborative for quality improvement." (Brown et al., 2020)