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Emergency Rooms Crack Down on Painkiller Abusers

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Emergency sign in front of Embergency/Trauma room

Doctor shopping is a common technique used by painkiller abusers to obtain drugs whenever one physician stops writing them prescriptions. To curb this dangerous habit, most states have implemented drug tracking databases which allow physicians to lookup patients they feel may be abusing painkillers like Oxycodone and Hydrocodone. These databases have gone a long way to lessen the abuse. However, these unintended consequence of these databases is that abusers now obtain their fix from emergency rooms.

The ER Painkiller Abusers Problem

Painkiller abusers visit hospital emergency rooms claiming to have a wide variety of ailments, which might not really exist. Most of the time, ER physicians provide them with a small supply of painkillers to ease the pain with instructions to visit their regular physician. Abusers then return repeatedly, claiming to have migraines one day and a backache the next. Part of the problem is that looking up patient prescription information in the standard database takes time which the ER staff simply doesn’t have. With overflowing waiting rooms and critical situations most simply want to treat the patient’s issue and move on to the next one, what is probably the biggest mistake right there.

ERs Respond to Painkiller Abusers Epidemic

As this abuse of ERs increased, it became clear that something had to be done. Some states have created an additional database specifically aimed at emergency rooms. Similar to the state-wide databases, these ER databases allow hospital staff to look up a patient’s name to see how often they have been given painkillers in the ER.
Though these systems are still in their infancy, it’s clear that they are already getting results. For example, the system used in Cheyenne Regional Medical Center, in Cheyenne, Wyo., flags the medical records of potential drug abusers with big red letters at the top. ER physicians don’t have to look anything up, as it’s already there when they access the patient’s file. The decision to label someone an abuser is made by a panel of physicians and administrators who look for a pattern of unusual behavior, such as multiple visits to the ER in a single month.
In Cheyenne’s case, patients classified as drug abusers are sent a letter informing them that they will no longer be given painkillers for anything other than a dire emergency. While this is a start, some drug treatment specialists don’t think it’s enough. Instead, they would rather see hospitals take the time to identify referrals for mental health care or drug abuse treatments based on each individual’s medical, emotional and financial needs.

Financial Benefits

Many ERs that have instituted these painkiller tracking programs did so claiming is a public health service. However, they are finding that the programs have also had a positive effect on the hospital’s bottom line. San Juan Regional Medical Center, in Farmington, N.M., found that their program reduced ER visits by 5 percent a year and saved half a million dollars a year due to these patients not having insurance.

Some Doctors Disagree

While many hospitals and physicians agree that this type of tracking is necessary, others disagree. They argue that dispensing medicine should be in the hands of physicians not hospital administrators. Dr. Alex Roseau, former president of the American College of Emergency Physicians, worries that these policies may prevent physicians from being able to displease painkillers when they are needed. Still, he agrees that steps have to be taken to curb the painkiller abuse problem in the U.S., which kills 44 people each day.

Source

Emergency Rooms Crack Down On Abusers Of Pain Pills. NPR. Retrieved on June 5, 2015.

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