To combat the growth of prescription drug misuse, Virginia hospitals are working together to prevent people from using emergency rooms to gain easy access to painkillers.
A task force formed by lobby groups for hospitals and emergency physicians has drafted recommendations to prevent addicts from bouncing between multiple hospital emergency departments in search of opioids.
Addiction to prescribed opioids -- painkillers such as oxycodone and hydrocodone -- is on the rise. In 2014, the Centers for Disease Control reported that 61 percent of drug overdoses involved opioids, a class of drugs that includes heroin. Health professionals says that prescription opioids can be a gateway to heroin use, which can be cheaper and more easily available.
Hospital emergency departments often are the place where addictions start, says Sean Connaughton, president of Virginia Hospital and Healthcare Association. Patients receive legal prescriptions but begin to abuse or sell the pills.
The list of recommendations was recently drafted by the Virginia Hospital and Healthcare Association and the Virginia College of Emergency Physicians. They'll be sent to most hospitals throughout Virginia to serve as a guideline for prescribing opioids in emergency departments.
The recommendations ask that doctors prescribe opioids for the shortest length of time possible. Hospitals also are encouraged to use the state’s Prescription Monitoring Database, which tracks the number of times a patient has been prescribed opioids for a single malady. Better coordination between emergency department and primary care doctors also is suggested.
Doctors also can have a difficult time knowing whether some patients are truly in pain or have an addiction, says Kirk Cumpston, a Virginia Commonwealth University emergency medicine physician.
“I think in your gut, being a physician, you want to help. And if they’re in pain or distress you want to remove that so you want to give them pain medicine. So it really tears at a lot of physicians,” he says. “They feel guilty if they don’t give them the prescription because they are in pain, and you can’t measure pain. There’s no objective way to know.”
The recommendations, announced yesterday, come shortly the CDC issued guidelines for prescribing opioids for chronic pain. This year, the Virginia General Assembly also adopted bipartisan legislation to combat prescription opioid abuse. One such piece of legislation calls for the creation a statewide criteria for indicators of unusual patterns of prescribing or dispensing prescription drugs. Another requires prescribers to consult the state’s Prescription Monitoring Database if prescribing an opioid for longer than a 14-day course.