Can process lower the opioid crisis?

Many years ago, I did a webinar on the importance of improving processes by providing a real-world example where a disaster could (and should) have been averted.

I'm sure you'll remember when, on April 20th, 2010, the Deepwater Horizon oil rig in the Gulf of Mexico erupted in an uncontrollable explosion fueled by oil and gas. The event killed 11 crew members and is touted as the worst oil spill in American history. Reports after the explosion showed that the crew missed three important steps in their operations. Run cement evaluation logs. Conduct negative pressure tests. And check the riser for displaced mud. Their processes were missing the "how-to" for these should-be-standard tasks.

These mistakes were being made, recognized, and ignored. This gross negligence in the process led to the inevitable: a complete breakdown. The unfortunate aftermath only exacerbated this fact.

The news is peppered with these stories about companies missing the mark, whether it's in developing new products nobody wants or making mistakes in their processes that lead to unfortunate catastrophes. Today, we're showing the other side of process improvement: the side where it can save lives if applied properly and proactively.

The opioid crisis: a prescription process issue

America is facing an opioid crisis: in 10 years, the number of drug overdoses caused by opioids has almost doubled. While the government is looking for potential solutions, like educational programs or the war on illegal drugs and fentanyl, those numbers continue to increase.

Unfortunately, many of these proposed solutions will be ineffective as they don't address the root cause. Of the millions of Americans who suffer from opioid substance abuse, only 22% are illegal drug users. This means the greater majority of substance abusers get their drugs through prescriptions. Yet, so far, very little effort has been made to change the prescription process.

According to a study by the Centers for Disease Control, the probability of an opioid addiction increases in accordance with the length of the prescription and the dosage. They found that patients who were prescribed opioids for at least one day had a 6% chance of addiction whereas prescriptions for 8 days or more showed a 13.5% chance of addiction after one year. In addition, higher dosages also lead to an increased risk of overdose in the future.

We can therefore conclude that the opioid crisis can be mitigated by tightening opioid prescription restrictions to ensure the stealing of pain pills for illicit use is prevented.

Can corporations help fight opioid abuse?

Unfortunately, as we've seen with BP in the past, enforcing these restrictions becomes complicated and muddled from government and politics. Throughout history, we've seen that government hasn't necessarily been effective or timely when it comes to industry regulations. Let's look at the tobacco industry as an example. The first studies showing negative effects of tobacco were published in the 1950s, yet the government passed its first law 20 years later, in 1970. In this situation, a quick solution is unlikely to stem from government regulations.

Perhaps if Corporate America were to get involved, we could accelerate the adoption of preventative measures? This is exactly what Walmart has set out to do.

Following the studies published by the CDC, Walmart is changing their prescription process. They've announced that they will fill first-time acute opioid prescriptions for seven days or less and limit the dosages per day. With over 5,300 Walmart and Sam's Club location nationwide, these process improvements are likely to have some effect on the population.

The importance of process improvement

While these real-world examples show large scale, nationwide problems, the process improvements to mitigate against them are rather small changes that both business and government can implement. In addition, these changes weren't demanded by customers, yet they add value (whether it's tangible or not) at relatively no cost to the company. In fact, the PR it attracts adds value in-and-of-itself.

We're not suggesting the government should step aside (as they have) and let the free market solve the problem. The free market model as a whole doesn't have the incentive to take responsibility. Although a few good-citizen businesses do step up and try to help even if there's no profit gain in doing so, this is a rare occurrence. There's a market failure when it comes to prescription drugs and their illicit use and our government is designed to help us all in these kinds of situations. Let's hope Congress can set politics or personal interests aside and work together across party lines, and with businesses, to change processes for the better.

On a smaller scale, perhaps there are improvements you can make on your own projects today that don't require many resources but could lead to a greater amount of value for the end customers. Though it may not be visible at first, many small, deceptively simple improvements over time can amount to bigger, more impactful results.

Written by Isabelle Blondin and Paul Dandurand

Photo by Quinten de Graaf