Overlook Medical Center makes significant strides to stem the tide of addiction
There was a time in medicine when pain was considered the “fifth vital sign,” and the prevailing ideology was that it must be addressed aggressively. In response, companies introduced evermore- potent pain medications, and physicians wrote more prescriptions for said medications. These are but two of the factors that contributed to the current opioid epidemic in America – there are numerous others – and now, says Chief Medical Officer John R. Audett, MD, “this country has a mess on our hands. All of a sudden, though, the pendulum has swung. Now everyone is talking about the opioid crisis, and we know, as a nation, that we’ve got to get serious about this problem.”
Medical associations and governing legislatures alike have begun calling for more stringent guidelines for opioid prescriptions. At Overlook, reports Dr. Audett, there has been a 60 percent reduction over three years in the number of patients leaving the emergency department with a prescription for an opioid. “The ED is a primary place where many of these prescriptions are written, so we looked at that area and started thinking about what we could do,” he says. “By increasing awareness while considering non-opioid solutions, we were able to achieve a significant reduction.”
That increased awareness has spread. Dr. Audett commends other departments for making their own inroads against opioid use. By way of example, he cites orthopedics, where doctors are injecting medication directly into surgical wounds to drive down the need for opioids; and general surgery, where doctors are using multiagent “cocktails” of non-opioid medications such as nonsteroidal medicines (ibuprofen, etc.) as alternatives to opioids. He further points to the benefits of properly educating patients. “A patient who is informed is much better able to manage pain,” he says. “The goal isn’t necessarily zero pain; the goal is that a patient is going to be able to get up and move and be functional. We are setting realistic expectations for patients.”