The Los Angeles County Board of Supervisors voted unanimously Tuesday to instruct the Medical Examiner-Coroner to begin sending letters to doctors notifying them if their patient has died from an opioid overdose.
Supervisor Janice Hahn and her coauthor Supervisor Hilda L. Solis proposed the new policy after an innovative study in San Diego showed that these types of letters reduce opioid prescriptions.
“This is a simple concept that works,” Hahn said. “When San Diego tried sending out these letters, doctors who learned about patient overdoses chose to reduce the number of opioids they prescribed. This is a creative and easy strategy that will save lives and I am eager to implement it in LA County.”
Of the 72,000 Americans who died from opioid overdoses in 2017, the CDC estimates that nearly half died as a result of an opioid that was prescribed to them by a physician.
To prevent addiction and accidental overdoses, educating physicians on the importance of safe prescribing practices is key. However, there has been a critical information gap. Physicians often had no way of knowing whether a prescription they wrote ultimately led to the death of their patient.
“The County Medical Examiner-Coroner is taking a proactive approach in attempting to curb the County’s opioid epidemic,” Solis said. “This is exactly the kind of innovative action we need right now to effectively combat our region’s opioid crisis and help save lives. Implementation of this simple but effective preventative program, which will influence physicians’ behavior when prescribing opioids, could be life-saving.”
Before becoming LA County Chief Medical Examiner-Coroner, Dr. Jonathan Lucas was working as Chief Deputy Medical Examiner in San Diego where he co-authored the groundbreaking study.
The medical examiner’s office began sending letters to doctors informing them when their patients died of opioid overdoses. The researchers then studied the doctors’ prescriptions following receiving the letter and found that doctors who received a letter wrote 10% fewer opioid prescriptions over the three-month study period. Now, Lucas will use these results to implement a similar program in LA County.
“Awareness works,” Lucas said. “Alerting doctors about patient overdose deaths is a unique opportunity for the department to have an impact on public health, effect change and potentially save lives.”
The letters will be informative, non-judgmental, and educational. They aim to alert providers about the potential dangers of opioid medications and how common death from misuse of these medications is in Los Angeles County.
After an opioid-related death, letters will be sent to all prescribers who wrote an opioid prescription to the deceased that was filled during the twelve months prior to their death.
Letters are expected to begin being sent in December 2018.