Health Care

Local Systems Respond To Opioid Abuse

By Ken Little, posted Dec 1, 2017
Major health care providers in the region, including New Hanover Regional Medical Center, Wilmington Health and Novant Health, are taking steps to address the rising tide of opioid pill abuse in the Wilmington region.
Jonathan Hines, chief medical officer for Wilmington Health, said his organization has been addressing the issue in numerous ways, including revamping narcotics agreements, providing more education about the dangers of opioid use and outlining the limits and responsibilities of patients and providers.
Wilmington Health has created monitoring systems in its electronic medical records (EMR) “so that with each prescription request, the physician can see the necessary monitoring parameters (urine tox screen, narcotics agreement, N.C. Controlled Substance Reporting System checks),” Hines said in an email.
In addition, the organization has created new templates in its EMR for the monitoring of patients on opioids; implemented a newly revised policy on the prescribing of chronic opioids that complies with the recent state legislation regarding prescribing; and has had educational sessions for the physicians on the dangers of opiate prescribing.
“This is an issue that is very much at the forefront of any of our physicians at this point,” Hines said.
On Oct. 17, New Hanover Regional Medical Center implemented new prescribing guidelines for opioids.
The guidelines are intended to curb misuse and abuse of opioids in the community and align with provisions of the North Carolina STOP Act that goes into effect in January, according to a news release from NHRMC.
The health care system’s new guidelines “establish a system that allows for opioids to be used for effective pain management while setting more structure around when they are prescribed and for how long,” the news release stated.
The guidelines also require providers to discuss known risks and benefits of opioids with patients so they understand when the time is right to discontinue the use of opioids. Information will also be provided about how to dispose of unused medication.
“As practitioners, it’s universally acknowledged that we need to do more to prevent opioid misuse. Now we’re helping practitioners with evidence-based guidelines to provide patients with the pain management they need while reducing the risks for misuse,” Kevin Cannon, who chaired the physician task force that developed the guidelines for NHRMC, said in the release.
In instances where opioids are needed, the new guidelines require prescribers to make the order electronically and prescribe the lowest effective dosage. Following discharge, prescriptions for acute pain will be limited to three to five days, with the exception of acute post-operative pain, which could be extended to seven days, the release states.
Novant Health, which operates Novant Health Brunswick Medical Center, is also taking steps to address the opioid abuse crisis.
A recent statement from the Winston- Salem based health care provider said that over the past 20 years, patients with pain disorders “have been treated with alarmingly high amounts of opioids, resulting in unintentional overdoses and even deaths.”
More people are now dying from opioid overdoses than from car accidents or gun homicides. In 2015, unintentional opioid poisonings took the lives of 998 North Carolinians, a 900 percent increase since 1999, according to Novant Health.
As a result of the crisis, Novant Health is developing polices to address the situation. A three-year initiative is in progress that will address the “appropriate prescribing of opioids for acute, post-surgical and chronic pain,” according to Novant Health.
The initiative also includes the use of multiple forms of pain therapies to reduce opioid prescribing and provide better pain relief; implementing alternative pain therapy such as massage, yoga and physical therapy; and the identification and treatment of patients with opioid use disorder or addiction.
“The nonmedical use and abuse of prescription drugs are serious public health problems throughout the U.S. It will take healthcare systems, government agencies and community organizations to come together to identify innovative ways to address this epidemic. Without these partnerships, communities will be unable to effectively address patient safety and improve the health of our communities,” according to the Novant Health statement.
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