Regardless of your location or patient population, being an emergency medicine physician in 2019 means playing a front-line role in America’s war on the opioid epidemic. We have an important and unique role in the opioid crisis. And, at American Physician Partners, we work hard every day to ensure that providers at our facilities follow safe prescribing guidelines and maintain compliance with the latest national standards in addiction treatment, to give our patients the best outcomes and experience possible.
In the ED, we do not get to choose the patients we see. Similarly, we do not get a choice in whether we treat addiction. It shows up at our doors nearly every single day. And, given the inherently fast-paced nature of our specialty, it’s often difficult to sit down with our patients to determine what health issues they are struggling with, beyond the acute ones which brought them into the ED.
Sometimes, we treat a patient’s simple pain problem. For others, what may have started as a pain problem has turned into something more. In those cases, it’s often up to the emergency medicine physicians to stop and ask themselves, “Am I able to have this conversation?”
If the answer is yes, it’s critical we do it with professionalism and compassion, offering the latest in evidence-based addiction care.
At APP, we understand addiction is a disease. We treat patients showing symptoms of opioid use disorder (OUD) like other chronic disease patients. In our communities, we are leading the way in increasing education around OUD and attempting to remove the stigma behind this disease.
It’s crucial for EDs across the country to implement formal protocols to get these individuals connected to the medical treatment they need. Here are a few key recommendations that we have seen as best practices to improve care for those suffering from OUD:
- Keep a supply of buprenorphine on-hand and be comfortable with its administration. This medicine has been proven to reduce mortality and lead to better long-term outcomes.
- Place counselors in the emergency department. Beyond an addiction crisis, America faces a mental health crisis, and EDs are seeing the consequences.
- Require doctors to take online CME courses on prescribing pain medication. The majority of today’s physicians have received little to no formal education around pain management.
- Set care protocols for effective ED treatment of OUD. For example, APP physicians never prescribe more than three days’ worth of pain medication.
- Register all providers with state prescription drug monitoring programs (PDMPs) to evaluate prescription amounts. Research shows that requiring prescribers to use state PDMPs reduces “doctor shopping” and other behaviors that may reflect opioid misuse.
At APP, we take pride in ensuring our nation’s EDs are prepared with standardized practices to address the opioid crisis in moments of urgent need, as well as solutions to improve the long-term health of our patient populations.