At the beginning of the opioid epidemic, providers prescribing opioids for pain management were identified by the media as culprits in the increase in opioid use disorder in the United States. This wasn’t completely unfounded; there were certainly some bad actors prescribing irresponsibly.

But for the vast majority of providers, these new and powerful drugs presented a genuine dilemma: balancing patient needs (and the very real experiences of patients with severe or chronic pain) with the risks.

Now, several years on, prescription monitoring programs like the one we use at the Washington State Hospital Association (WSHA) are providing hospitals like mine with big-picture data about prescribing rates. This information is already helping providers to be more thoughtful in how they approach pain management, offering patients a broader set of tools to manage their symptoms. Through the collaborative efforts between WSHA and providers, we have seen year over year improvements in appropriate opiate prescribing using state and national guidelines.

But prescribing is only one piece of the puzzle. We know that almost half of people who misuse prescription pain relievers get them from a family member or friend. And we know that providers are trusted message carriers, and uniquely positioned to influence their patients’ behavior.

It is important to note that opioid prescribing is still necessary for many patients, but I believe that providers have both the opportunity and responsibility to partner with our patients in a collaborative approach. Now, when we do prescribe opioids, we have a better set of tools to encourage safe and responsible use such as locking up medications, safely disposing of them when the drug is no longer needed, and never sharing prescriptions.

Campaigns like Starts with One, which is funded by the Washington State Health Care Authority (HCA), are enabling providers to be leaders in preventing opioid misuse by talking openly with our patients about what happens once they fill a prescription. Over the last two years, HCA has partnered with WSHA to strategically activate providers in the effort to combat misuse.

I’m glad to see more of my colleagues and hospitals across the state take action as leaders in these efforts, using resources like the Starts with One prescribing guidelines checklist and other materials to educate themselves and their patients, and proactively seeking out additional opportunities to learn, like HCA’s Region 10 Opioid Summit in Vancouver that took place this summer. But the work is only just beginning.

I am convinced that by continuing to better understand the world our patients are stepping into once they leave our hospitals and clinics, we can and should be influential partners in reducing prescription opioid misuse in our communities.

All of us — patients and providers alike — need to be empowered to start the conversation about safe opioid use. It starts with one, and it’ll take all of us.

Dr. Ettore Palazzo is the Quality Medical Director at EvergreenHealth and the chair of the Washington State Hospital Association’s Safety and Quality Committee.