Amidst national epidemic, Sentara emergency department updates opioid prescription policies

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If current trends continue, the number of reported fatal opioid overdoses in Virginia reported in 2016 will be 77 percent higher than figures from just five years ago. (Courtesy of Sentara)
If current trends continue, the number of reported fatal opioid overdoses in Virginia reported in 2016 will be 77 percent higher than figures from just five years ago. (Courtesy of Sentara)

Last year, 806 people died from opioid-related deaths in Virginia. This year, it’s estimated that more than 1,000 people will meet the same fate. In November, Surgeon General Vivek Murthy declared a national opioid epidemic.

To limit the number of opioid prescriptions, Sentara emergency departments are changing the way the addictive drug is prescribed to patients in pain. Starting Jan. 1, 2017, all Sentara emergency departments and freestanding emergency rooms will update their policies to follow new recommendations from the Centers for Disease Control and the American Hospital Association.

The biggest changes are that Sentara will no longer use intravenous or intramuscular opioids to treat chronic pain, replace lost or stolen opioid prescriptions or prescribe long-acting opioids like oxycodone, extended release morphine, methadone, buprenorphine, hydromorphone or fentanyl patches. When a patient is prescribed an opioid for treatment, they will not receive more than 20 pills.

“The important thing is that the goal of all this is to prevent addiction,” said Brian Jones, manager of the emergency department at Sentara Princess Anne Hospital. “We want to treat people with acute and chronic pain, but responsibly.”

As of Dec. 6, there were 253 opioid-related overdoses in Virginia Beach. Of those overdoses, 50 resulted in deaths. In the same time period in 2015, there were 127 opioid-related overdoses with 33 resulting in deaths. Last week, the emergency department at Sentara Princess Anne saw three overdoses, though none were fatal.

“Luckily, we saved their lives,” said Heather Murphy, director of the emergency department at the hospital. “But we are seeing an uptick in patients coming into the emergency department that have overdosed on heroin.”

One of the primary concerns is that, sometimes, when a patient is no longer prescribed the opioids they used for treatment, they will seek out other alternatives. One of those alternatives, Jones said, can often be illegal drugs like heroin.

“It’s much cheaper and easier to get,” Jones said. “So, we have to nip the problem at the source.”

Sentara physicians will also use two systems – one that is specific to their emergency departments and another that is viewable by any physician or pharmacist statewide – to monitor patient prescriptions.

These systems will allow physicians to see if a patient has visited another emergency department or prescribed opioids previously, which will help to determine if a patient might be dependent on an opioid medication.

“If someone has used it before, but responsibly, we would not discriminate against them for that reason,” Murphy said. “If they are a chronic opioid user, they’re not going to get an opioid.”

Opioid-related deaths have been on the rise since 2012, but Sentara first took notice of the problem years ago, according to Dale Gauding, communications advisor for Sentara Healthcare.

“We’re not just reacting because it’s in the headlines,” Gauding said. “We’ve been proactive about this for a number of years. We talked about limiting the use of opioids because it was becoming a problem back in 2007.”

To educate patients about acute and chronic pain treatments, all Sentara emergency departments will create and use brochures that will detail possible treatments options and physicians can also help patients find substance abuse services.

Though policies and prescriptions will soon change, Sentara will continue to treat every patient in need.

“We don’t want the public to feel like emergency departments will be discriminating against or turning anyone away,” Murphy said. “We just want to make sure our community and our patients are safe.”

This story was published in partnership with WYDaily’s sister publication, SouthsideDaily.com.