In the Know column: Health system works together on opioid crisis

About 1.6 million Americans have an opioid use disorder. Taking opioids for longer than three months increases your risk of addiction by 15 times.

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Editor's note: For this week's In the Know column, Carl Vaagenes, CEO of Alomere Health asked Dr. Deb Dittberner, MD, MBA and CMO of Alomere, to take his place.

By Dr. Deb Dittberner, Alomere Health

Let me start with a Native American parable.

Three sisters went out for a walk one day. As they come up to a rapidly moving river, they were shocked to see many babies and small children bobbing and drowning in the river.

The first sister quickly laid down on the bank and with her strongest reach began to grab as many of the children as she could and threw them onto the dry ground.


Without hesitation, the second sister dove into the water and helped children float upright and taught them how to swim.

The third sister stood at the shore, quickly pondering on how to help and wondered “Why are there so many babies and children drowning in the river?” Without a moment longer of hesitation, she ran up the river to find out "why" and to stop the children from falling into the river.

I frequently use this parable when trying to improve health and wellness outcomes on specific issues affecting our community. One of these issues has been the opioid crisis, and it has been a main focus of my work as Chief Medical Officer at Alomere Health since the fall of 2014.

Dr. Deb Dittberner

Some history for my readers. In the late 1990s, drug companies began campaigning in the medical community for prescribers to increase use of "new opioid pain relievers." They even lobbied the FDA to label these drugs as "not-addictive." This led to misuse of these medications and quick realization that there were highly addictive for patients. Because of this and other stressors in our society, we had a growing problem.

As of 2020, 3.7% of Americans misuse opioids at least once a year. About 1.6 million Americans have an opioid use disorder. Taking opioids for longer than three months increases your risk of addiction by 15 times. Most people rarely need more than seven days worth of opioids for acute pain.

Everyone could feel the impact of the opioid crisis in the Alexandria area. So how have we used this wise parable successfully on the opioid crisis?

The first sister is our pharmacies, Emergency Medical Services (ambulances), police officers/first responders, emergency rooms, and clinics. They recognize overdoses and potential for overdoses. They not only administer the emergency medicine, Narcan (Naloxone), to save lives but also prescribe it in high risk situations as prevention. They work together and communicate efficiently.

The second sister is evident in both our health system and community. Written grants have been able to create a strong team of physicians, nurses, pharmacists and social workers in the clinic. That team identifies high risk prescribing and helps patients recover with medication assisted treatment (MAT) from addiction and refers those patients to abundant community resources.


Since 2015, we have lowered narcotic prescribing with in our system by 70%. We have an ever growing number of patients on MAT. Our Community Taskforce meets regularly and has over 70 members with incredible attendance. At the meetings we share success stories, offer resources, and make critical and enduring connections.

The most important thing the Community Task Force realized is that our community needed to be that third sister. We needed to recognize and battle the Social Determinants of Health (SDoH) and Adverse Childhood Experiences (ACEs) in our community that are estimated to affect 80% of healthcare outcomes.

Additional research has revealed that working on SDoHs and ACEs could decrease healthcare costs in the U.S. by $1.7 trillion per year .

Successful system and community models have already shown up to a 11% decrease in health care spending by taking on SDOHs and ACEs

Decreasing the medical and community health care spending is an important goal, but not a primary goal. The focus needs to be on the patient, that community member. We need to help them live their best life, healthy and well.

It’s also Alomere’s mission for our community: “Our passion and purpose is to strengthen and nurture the health and well-being of our family, friends, neighbors and community.”

In closing, we received a message after one of our Opioid Community Task Force meetings from a community member who had attended for the first time. It energized all of us: "It was like stepping into another realm; it was so amazing to see all these people coming together to make our community an even greater place to live.”

Never underestimate the power and purpose of that third sister no matter what the focus or problem might be. I encourage every reader to become the third sister with us. Find your role to help us as encourager, promoter, volunteer or leader. Let’s go up stream together and continue to make this a great community where every member has the opportunity for health and wellness.


In the Know is a rotating column written by community leaders from the Douglas County area.

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