Healthy Connections Spring 2020: In Focus

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Rethinking Pain Therapy

Vidant North Hospital takes steps to confront the opioid crisis

Pain management is one of the most searched-for topics in healthcare content. From aspirin to alternative medicine, people are searching for ways to deal with acute and chronic pain. In the last decade, many people have become accustomed to treating pain with opioids, a practice so common that it triggered a healthcare crisis, the impact of which will be felt for at least a generation. As the opioid crisis continues to impact communities, healthcare professionals and would be patients alike are rethinking their reliance on opioids for pain management and looking for alternatives while dealing with the damage already done by these painkillers.

Opioids are a class of drugs that interact with receptors in the body and brain. While opioid pain relievers are safe for short-term use, their ability to produce euphoria also makes them susceptible to abuse. Misuse of opioids can lead to dependence, addiction and even death. Of the combined opioid overdose deaths in North Carolina and Virginia in 2017, one-third involved prescription opioids.

Opioid dependency carries a high economic price tag, too. According to a 2018 report by The American Action Forum, rising opioid prescriptions from 1999 to 2015 resulted in 41,400 men and 58,200 women being absent from the North Carolina labor force in 2015. Virginia was less affected during the period, with 8,100 men and 10,800 women idled in 2015.

Vidant North Hospital began formally addressing opioid misuse in 2015, with the implementation of a new Emergency Department pain policy aimed at curbing opioid medication overdoses and deaths. The policy restricts chronic pain treatment to nonnarcotic solution prescriptions, such as ibuprofen (Advil), acetaminophen (Tylenol) and aspirin. Acute pain events requiring a narcotic or sedating medication now require presentation of a government-issued ID or photo taken by staff that is placed in the patient’s medical record. Doctors also check patients’ prescription history in federal and state databases. The Medical Center also transmits all prescriptions via email, eliminating handwritten prescriptions that may be lost or stolen.

Opioids trigger the release of endorphins, causing a sense of euphoria. Some people who are prescribed opioids may develop a tolerance, requiring higher doses to manage their pain, or a dependence. The Centers for Disease Control report that anyone who takes prescription opioids has the potential to become addicted to them, and as many as 25% of patients receiving long-term opioid therapy in a primary care setting face opioid addiction. Charles Miles, RN, manager of patient care in Vidant North’s Emergency Department, says people can be vigilant by looking for signs of opioid misuse in friends and family, such as withdrawing from family and old friends, loss of interest in favorite activities, weight loss or pallid, unhealthy complexion. When talking about suspected opioid misuse, Miles recommends being open and honest without being judgmental; let the person know that you care and only want to help. “You need to understand that you can’t do it for them,” Miles says. “They have to make the decision they want help.”


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