Unintentional drug overdose deaths is now the second leading cause of accidental death in the United States. With the alarming increase of prescription drug abuse, our nation and our community are facing a national epidemic with local consequences.
This national challenge is creating a disturbing trend in Lee Memorial Health System emergency departments as an increasing number of patients are coming to the ED for the sole purpose of obtaining pain medication. More and more patients with chronic pain are using controlled substances prescribed by many different doctors and now are frequently seeking more opioids through our EDs. So, with the support of the Lee Memorial Health System Board of Directors, local law enforcement, and elected and community leaders, we have adopted new voluntary guidelines for prescribing and dispensing pain medication—particularly opiods—in our EDs.
Aaron Wohl, M.D., Chairman of the Emergency Departments at Lee Memorial Hospital and HealthPark Medical Center, has spearheaded our system wide efforts.
“As many as seven Florida residents die every day as a result of prescription drug overdose,” Dr. Wohl says. “How concerned would our community be if that many dolphins washed up on Florida’s shores every day? We have to put a stop to this. As physicians, we have a dual obligation to relieve pain, while preventing personal and societal harm from prescription drug abuse. While our ED physicians remain committed to alleviating pain and suffering of acutely painful conditions, we believe that chronic noncancer related pain is best managed between patients and a single primary care physician or pain management specialist in a properly monitored outpatient setting.”
The guidelines are consistent with new state laws and encourage the use of Florida’s new prescription drug monitoring program to better identify patients at risk for abuse. The guidelines also promote improved discussion among doctors and patients regarding best and most appropriate options for pain care. Our ED physicians will work with our community resources to help connect patients with the follow-up care they need.
“Our goal is to reduce controlled substance dependence, abuse and diversion while coordinating the care of those patients suffering from genuine chronic pain,” Dr. Wohl says. “We are not alone in this. Fifteen other Florida institutions and Orlando area hospital EDs have established similar guidelines. These changes are a bold first step, as we do our part to solve this very complex national problem.”
As health care professionals, we always want to do what is best for our patients, their families and our community. Rationally and appropriately prescribing pain medication is the right thing for our community. Reducing risks from overuse of narcotics also is the right thing for our community.
Thank you to Dr. Wohl and all of our health system ED physicians for standing up to fight this growing and often devastating problem. You are doing the right thing; you are caring people, caring for people.
President, Lee Memorial Health System