ORLANDO, Fla. (January 18, 2012) --- Emergency physicians at Florida Hospital and Orlando Health are responding to patients seeking pain medications, but not necessarily with a prescription. The area’s two largest health care organizations are prescribing a dose of empowerment, education and encouragement. A new Chronic Pain Management Plan empowers patients to take responsibility in the safe use of pain management treatments, educates patients about the dangers of misuse, abuse and addiction, and encourages patients to seek the best setting to care for chronic pain management conditions.
“The prescription drug problem is a local and national public health concern,” said Josef Thundiyil, MD, Orlando Health. “Emergency departments are treating more and more patients with prescription drug abuse related injuries and seeing more deaths. Deaths related to prescription drug use in Florida have even surpassed deaths from other common killers including motor vehicle crashes. Related injuries are on the rise also.”
Added to the challenge, some attempt to use Emergency Departments as an alternative method to pain clinics to obtain medications or prescriptions for pain medications. In addition, others visit Emergency Departments to seek treatment for chronic non-malignant pain.
The recent spike in patients comes on the heels of tougher laws and legislation to reduce the number of pain clinics and limit prescribing, and more aggressive policing by law enforcement agencies which has led to an increase in arrests and seized medications.
“We support initiatives to prevent abuse, addiction, diversion, injuries and deaths from prescription medications. We have seen the impact on emergency departments which has included more patients and increased use of resources,” said David Goldman, DO, Florida Hospital. “Both hospital teams met and asked ourselves, ‘What can we do to continue to ensure appropriate medical care for those in need, offer assistance to those in need?’ We developed a plan that helps empower patients to take responsibility in pain management, educate them about the dangers of abuse, and encourage treatment in the proper clinical setting.”
The policy includes guidelines for clinicians in considering treatment to ensure appropriate care, and encourages and involves more discussion among doctors and patients about pain care. The policy also includes various referral options for pain care (primary care physicians or behavioral modification programs) and includes pain medication signage inside emergency departments.
What the policy does not do is withhold pain medication from patients with medical needs.
“As emergency physicians, we understand that pain is real when someone is hurt or needs emergency care,” said Dr. Thundiyil. “We know the importance of appropriately alleviating pain for traumatic injuries and acute illness. We have done so for years and will continue to do so. However, a different approach is needed when some patients visit the emergency department for medical conditions that require long term pain management.”
Chronic pain medication is best managed between patients and their primary care physicians rather than emergency physicians who are unable to establish the long term relationship needed to appropriately treat and manage recurring pain and prevent life threatening side effects. Because sporadic, episodic care of chronic pain management may lead to worse outcomes – poorer control of pain, more side effects of medication, and increased potential for addiction, substance abuse, and community diversion – proper pain management is the best solution for the best outcomes. Referring these patients to community resources is vital to this plan.
“That physician referral to the appropriate resources is so important,” said Stacy Seikel, MD, Medical Director for the Center for Drug Free Living. “If people leave the hospital and don’t know where to turn for help, their addiction will just continue. That is why we are standing by Florida Hospital and Orlando Health and this shift in their emergency room approach. We stand ready to make sure any substance abuser in Central Florida can receive treatment.”
The organizations hope those who need help will take advantage of referrals to behavioral modification programs, and that the policy sends a strong message to and eliminates the number of those only seeking prescription medication for non-medical reasons.
“I applaud Florida Hospital and Orlando Health for taking the initiative to tackle this issue head on,” said Orange County Mayor Teresa Jacobs. “If we are going to put a stop to the prescription drug epidemic in our community we must combat it from all angles. Getting the hospital emergency rooms and their physicians involved is an important part of making progress.”
Helping patients better manage pain helps patients get the care they need where they need it and helps in the management of the community’s Emergency Departments.