Beginning Tuesday, the emergency room at Baptist Memorial Hospital-Golden Triangle will limit pain medication doctors and nurses give to patients with chronic pain complaints.
This new policy falls in line with guidelines from the Center for Disease Control, said ER Doctor Joel Butler, who has worked at Baptist for about 30 years.
As an episodic treatment center, ER doctors and nurses are unable to monitor the effects of pain pills the way a regular doctor can.
“The (CDC’s) recommendation is that the medications are best given by a patient’s regular physician who sees the (patient) on a regular basis, … like any other regular medicine the patient takes,” Butler said. “Because the physician needs to monitor their response to the medication … and we just cannot do that adequately in an episodic care situation.”
The ER at Baptist sees between 175 and 190 patients per day, and about 90 percent of them are dealing with some type of pain, said Lauri Sansing, nurse director of the ER. A physician or nurse practitioner evaluates the patient to determine what type of pain they’re in and what medications they need.
“We look at the patient as a whole,” she said. “We’re not looking just to see (if they’re) coming back in just to get another prescription refill to get more pain medicine, but we’re just trying to impact what our addiction level is in this area for our county and to impact the overall national epidemic.”
Patients who come in with acute pain, such as broken bones or stab wounds, will still get whatever pain medication they need, Butler added.
But the ER is making these changes because of the opioid epidemic.
“There’s an epidemic of opioid overdose going on in the United States,” Butler said. “It’s increased by a factor of four since 2000, and about half of all those is prescribed medication.”
In 2015, more than 33,000 people died in the United States from opioid addiction or overdose, the highest number on record, according to the CDC’s website. Nearly half of those were from opioid medications.
Abuse of prescription drugs is something the Lowndes County Sheriff’s Office’s Narcotics Unit sees on a daily basis, Capt. Archie Williams said. The unit catches addicts with drugs like oxycodone, hydrocodone or Aderall easily as often as they see methamphetamines, he said.
“It’s very, very common that we see people with controlled substances such as … Lortabs, oxycodone, percosets, any of those type stuff.”
While addicts and dealers sometimes get their hands on pills by burglarizing pharmacies or, in the case of minors in particular, stealing from family members’ medicine cabinets, plenty of them get the pills straight from doctors, Williams said.
“(People will) go to the emergency room, complain of back pain, neck pain, whatever they have to say in order to get a prescription for some kind of pain pill,” Williams said. “And then they’ll get their prescription filled. You’ll either have your addict that does that and takes them themselves or you’ll have a dealer — or somebody who’s trying to make money — do that very same thing, get those prescription filled and go sell them themselves.”
Therapists at Baptist Behavioral Health see the same problem.
“We do have a significant number of patients that we see come in for chemical dependency or other diagnoses that are complicated by chemical dependency,” Baptist Behavioral Health director Rick Freeze said. “Eight of our 30 beds over there are licensed as our chemical dependency beds, and they stay full.”
Many of the patients at Baptist became addicted after being prescribed pain medication for a surgery or sports injury, Baptist Behavioral therapist Janae Turner said.
“Our body stops being able to naturally fight that pain, and so we need to take more and more and more, and we become dependent upon it,” she said. “Once we’re dependent upon it, it’s very difficult to stop taking that medication because there’s a great increase in pain when that happens. So we’re kind of seeing this trickling effect.”
The other problem is prescription pill addicts may shift to using street drugs like heroin more easily, Sansing said. Heroin overdoses have spiked with prescription pill overdoses in other parts of the country.
Williams said his unit hasn’t seen much heroin in Lowndes County, but he worries addicts might turn to heroin if it becomes more difficult to get prescription drugs. But he said, as far as he knows, communities where hospitals have implemented similar policies to Baptist’s have not necessarily seen a sudden increase in heroin.
“That’s more of a personal worry,” he said.