Contractor pitches —billion pill pledge' program to reduce post-surgical opioid exposure in Sweetwater County

A representative of Goldfinch Health briefed the Sweetwater County commissioners on the 'Billion Pill Pledge' program, a statewide and national initiative that seeks to reduce new opioid dependence following surgery by changing prescribing practices, providing nurse follow-up and ensuring safe disposal of unused pills.

Why it matters: Goldfinch Health presented county-level prescribing figures showing Sweetwater County had 73.8 opioid prescriptions per 100 persons, higher than the Wyoming statewide rate cited (43 per 100). The company estimates large numbers of unused opioid pills are created after surgeries and argued preventing initial exposure is an effective prevention strategy.

Program components and evidence: Patrick Madigan of Goldfinch Health said the program uses four elements: academic detailing for hospital clinical staff (education on nonopioid pain-management pathways), remote nurse follow-up for post-operative patients, a "prepared for surgery" toolkit (nonopioid therapies and instructions) and safe-disposal Deterra bags for unused pills. Madigan cited published studies and a peer-reviewed evaluation of their pilot program in Iowa showing lower opioid prescribing and reduced refill rates.

Funding and next steps: Madigan said the program can be funded with opioid settlement dollars and that some counties and municipalities already contract for the service. Commissioners signaled interest and noted the county has an opioid committee and a recent needs assessment; county representatives said staff and the hospital would be appropriate next contacts. Goldfinch Health offered to meet with the hospital and local stakeholders to outline a proposal.

Discussion vs. decision: The presentation was informational; commissioners did not vote to contract with Goldfinch Health at the meeting. Commissioners and staff agreed to pursue follow-up meetings with the hospital and the opioid committee to consider whether settlement funds could support the program.

Quotes: "Every year after surgery, there are 3,000,000,000 opioid pills left over after surgery in America," Patrick Madigan said, summarizing the program's rationale. Madigan also said the company's intervention produced a 60 percent reduction in post-surgery opioid prescribing in prior implementations.

Ending: Commissioners asked staff and the opioid committee to continue evaluating how opioid-settlement funds could be used locally and to consider a follow-up Goldfinch Health presentation to the hospital and stakeholder group.