The normal report shows only the increase in drug overdoses … and almost exclusively each is labeled as ACCIDENTAL… this study shows that INTENTIONAL suicide/overdose has increase 3-4 times the rate of ACCIDENTAL overdoses… Could this be because of under/untreated pain and under/untreated mental health issues?
Feb. 16–This is part seven of a multi-part series on the misuse of prescription pills.
As prescription pills gain popularity among recreational users, the number of overdose cases at hospital emergency department visits is rising as well.
Already the number of people abusing pills has reached unprecedented levels throughout the country.
Nationally, emergency visits linked to prescription painkillers, including Oxycodone and methadone, jumped 111 percent within a four-year period from 2004 to 2008, according to a study released in June by the Substance Abuse and Mental Health Services Administration and the Centers for Disease Control and Prevention.
A separate study found that hospitalizations linked to both intentional and unintentional overdoses have also risen dramatically over the past decade. Findings of the study, reported in the American Journal of Preventative Medicine, indicate a 37 percent jump in hospital stays between 1999 and 2006 due to unintentional overdoses of opioids, such as Vicodin and Percocet, and sedatives, such a valium. Suicide-related overdoses on the same drugs increased by a staggering 130-percent during that same time frame.
Furthermore, the study found that hospital stays linked to improper use of opioids, sedatives and tranquilizers, excluding overdose cases, have also increased throughout the country by 65 percent during a seven-year period.
MedWest-Haywood Emergency Department Director Roger Coward said the same trend is playing out in Haywood County, where emergency room visits and hospital stays have climbed alongside the spike in prescription pill abuse numbers and related deaths.
Although hard numbers are not available at this time, Coward estimates at least one-third of all psychiatric patients are admitted to the hospital for monitoring during the sobering-up process are due to over-intoxication issues from both pills and alcohol. Critical cases must be admitted to the intensive care unit.
Although the number of overdose-related deaths is staggering, the number of individuals who abuse pills and end up with a permanently life-altering condition, like Pisgah High School’s recent graduate Tyler Treadway, are just as alarming, said Coward. At 19 years old, Treadway is wheelchair-bound and unable to communicate due to a severe brain injury stemming from an overdose on prescription pills.
“Cases like the Treadway case happen more frequently than anyone realizes,” Coward said.
Currently, depending on the doctor, the emergency department at Haywood Regional dispenses its “fair share” of narcotic pain medication, Coward said. But that may soon change.
Coward and others in the medical community, are working to draft a new hospital policy that will, among other things, control the quantity of pain pills prescribed through the hospital emergency department, as well as the types of narcotics that are dispensed.
“One challenge we’re going to have to look at from the perspective of the hospital system is, we need to be proactive about how narcotics are dispensed from our facility,” he said. “We’re looking at policy changes … I am not the one to dictate the policy about the administration of meds. I facilitate policy development, but when it comes to actual policy, we rely on (doctors) to help us. I’m not going to dictate what they can give. That’s their call. But as a medical community we need to come together on this … We don’t want patients being in pain. We want to treat their pain, but at the same time we’ve got to be very careful about how we dispense.”
Changes to current hospital policy will aim to cut down on the amount of pain treatment administered through the emergency department, in addition to limiting the quantity of pain pills that may be prescribed. It may also restrict emergency room doctors from prescribing certain narcotics, like Oxyconton and/or methadone.
“One thing we’ll be looking at is how do we monitor and control (pain treatment) in the emergency department, so that doctors are not (writing scripts) for 90 or so Percocets, for example,” said Coward. “We’ll be looking to develop a plan to dispense only up to a 24-hour allotment of pain medications. Beyond that, patients will be (advised) to follow up with their primary doctor. This making multiple visits to the emergency department (to get pain pills) will not be acceptable.”
Different doctors prefer different types of pain treatment, Coward said of the contract physicians who staff the emergency department at MedWest-Haywood. Some are more apt to prescribe pain pills than others, “so it’s kind of a gamble when one comes into the ER, whether they are going to get any pain pills or not. I handle a lot of complaints from people who said they came into the ER, but weren’t treated for their pain. That’s probably not true. There are a lot of ways to treat pain, other than with (narcotic) meds.”
If someone comes into the ER with a bone sticking out of their leg, “obviously we’re going to treat it,” he continued. “But if someone comes in needing medication for back pain that they’ve been experiencing for five years, then they need to see their primary physician. … We may treat the back pain for a temporary time, but then they need to follow up with a primary physician.”
Another tool in place to assist doctors treating pain is an electronic database linking 16 regional hospitals, including MedWest-Haywood, which tracks a person’s medical history including emergency room visits to hospitals within the region.
The Data Link tool maintains an electronic log of patients’ medical records.
“So, when a person visits our hospital, ED doctors can look and see within the 16-hospital radius where other emergency room visits were made and what was prescribed,” said Coward. “It’s a way for us to monitor patients who are doctor shopping.”
The database is available to doctors along with the prescription pill monitoring program — a national program that logs information provided by pharmacists, detailing all narcotic prescriptions issued within the 42 participating states throughout the country. Both databases track patient prescriptions, but doctors are not required to use either tool.
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Filed under: drug overdoses/mis-use
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