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Emergency Rooms Crack Down on Abusers of Pain Pills

Hospital panel meets monthly to decide who gets ‘flagged’

In the last few years, emergency rooms (ERs) have become popular destinations for drug abusers seeking prescription painkillers, such as Vicodin or Percocet, according to an article posted on the National Public Radio (NPR) website. In response, hospitals in some states, including New Mexico, Texas, and Wyoming, have developed tracking systems specifically tailored to the ER.

The program used by the ER at the Cheyenne Regional Medical Center in Cheyenne, Wyoming, is just getting off the ground. Speaking to an NPR reporter, ER director Tracy Garcia pointed out the bold red letters that appear on patients’ electronic records when they’re flagged as drug abusers. With Wyoming’s existing prescription monitoring system, she said, it hasn’t been easy to track abusive patients. The ER’s doctors work 12-hour shifts, serving an overflowing waiting room — which can mean that, even if they find a patient suspicious, Garcia said, they can’t always look into it.

Under the new system, the decision of whether to withhold addictive painkillers won’t be made by the doctor on duty, Garcia said. Instead, a hospital panel consisting of doctors and administrators will meet once a month to decide whether patients flagged for unhealthy behavior should officially be labeled as abusers. The panel will be watching for signs — such as more than a few visits to the ER in a given month.

Once the patients’ names have been flagged, the hospital will send out certified letters telling them they will not be prescribed painkillers for anything other than a dire emergency.

This kind of program has already had an impact at hospitals around the country, the NPR article says. Dr. Eric Ketcham helped create one at San Juan Regional Medical Center in Farmington, New Mexico, a few years ago.

“We assumed we would probably lose money,” Ketcham told NPR. “We thought of it as a public health initiative.”

Instead, the hospital cut down the number of visits to its ER by 5% a year. And because many of these narcotic-seekers lacked insurance, eliminating their repeat ER visits saved the hospital about half a million dollars a year, Ketcham said — enough to pay for six full-time nurses in the emergency department.

Still, some doctors are nervous that these kinds of programs could tie their hands, NPR says.

“It’s very important to leave medicine in the hands of physicians,” said Dr. Alex Rosenau, former president of the American College of Emergency Physicians. One of the purposes of the ER is to treat people when their primary care doctor is unavailable, he pointed out –– and for poor people, it’s sometimes the only medical care to which they have access.

The new guidelines may discourage doctors from giving out pain medications when they’re really needed, Rosenau said. Still, he agrees that the question of who should get painkillers and who shouldn’t is more important than ever. In 2013, prescription-drug overdoses killed 44 people, on average, every day in the U.S.

Source: NPR; June 3, 2015.

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