PORTLAND, Ore. - Federal health authorities say prescription drug abuse is the nation's fastest-growing drug problem. This week, doctors and nurses working in Oregon hospital emergency rooms have adopted new guidelines to try to curb the abuse of prescription painkillers. They say that every day, they walk a fine line between addressing patients' real pain issues and playing into the hands of those who are addicted to the drugs or selling them.

Oregon has a relatively new Prescription Drug Monitoring Program to help prevent multiple prescriptions going to the same person, and emergency room physician Dr. Sharon Meieran says the additional guidelines will help.

"This isn't something we're doing to be punitive or to deny people treatment. It really is a huge public safety and public health issue right now and, you know, we want to be part of the solution."

The guidelines cover opioid drugs like OxyContin, Demerol and methadone. They include not prescribing to people without a valid ID, and not providing replacement prescriptions.

Emergency room workers like Dr. Meieran say they see people who come back time and again, and have heard all the excuses for needing a new prescription.

"It's kind of like 'The dog ate my homework'. . . the dog ate their prescription. A lot of people, you know, 'I was on the bus and my prescription for OxyContin was stolen.' If we don't have the objective proof, we're not going to just issue these duplicate prescriptions."

The guidelines also suggest that emergency room workers ask questions about substance abuse, and even provide brief interventions and treatment referrals. Dr. Meieran thinks they'll be a catalyst for getting more people the help they need, even in a busy emergency room.

"You can point to the guidelines, and I've had really great conversations with people. People admit, 'Yeah, I think I'm addicted to these, and I don't know what else to do, I don't know how else to get them, I don't know how else to treat my pain,' whatever it is. So then, you can start doing something more productive."

The Oregon guidelines are voluntary. The precautions are modeled after those in other states, including Washington, where they are required by law.

The guidelines are online this week at ocep.org.




get more stories like this via email

Toughing it out during spring allergy season is not in your best interest if you want to avoid asthma later in life.

New Mexico has plenty of grass and weed pollens carried by the wind which contribute to itchy, watery eyes, a stuffy nose and sneezing fits this time of year.

Dr. Osman Dokmeci, associate professor of internal medicine at the University of New Mexico, suggested for those who suffer acutely, seek an allergy test and possibly medication to prevent asthma from taking hold.

"One out of 10 has asthma in America," Dokmeci pointed out. "Having seasonal allergies increases your chance of developing asthma at least fivefold."

He recommended treating allergies early and as aggressively as possible. May is "Asthma Awareness Month," which aims to bring attention to the health issue and highlight improvements in care and quality of life. Nationwide, asthma affects more than 25 million Americans, including 4 million children, and disproportionately affects certain racial and ethnic groups.

Allergies do not "cause" asthma but people who have allergies, or have family members who have allergies, are more likely to get asthma than those who do not. Research shows allergy season is starting earlier and lasting longer. A 2022 study from the University of Michigan found pollen count could increase by 200% by the end of the century due to climate change, which is why Dokmeci stressed it is important not to ignore the problem.

"There's no treatment that actually makes your asthma not happen," Dokmeci explained. "But once you develop asthma, there are good treatment options."

The estimated economic impact of asthma is more than $80 billion per year from direct and indirect costs, such as missed school and workdays.

Recent research shows approximately half of people who die by suicide had contact with a health care professional within the month prior to their death.

However, a recent study shows only 8% of hospitals are currently implementing all four recommended suicide prevention practices: safety planning, warm handoffs to outpatient care, patient follow-up and lethal means counseling.

Melissa Tolstyka, director of Behavioral Health Services for Trinity Health Ann Arbor, said a seamless transition from inpatient to outpatient care is critical. At Ann Arbor, she saw a 46% increase in compliance with comprehensive suicide risk assessments and patients discharged on the suicide care pathway now receive a safety plan, which she sees as progress.

"We continue to see a need for really robust programming," Tolstyka explained. "Not just within the behavioral health world, but in the medical world as well. Our organization really wanted to focus on bringing the behavioral health and the medical services together to enhance our safer suicide care practices for our patients."

The initiative is being piloted across various units at Trinity Hospitals in Ann Arbor and Grand Rapids including the emergency department, psychiatric medical and inpatient nursing units. If you or anyone you know is struggling or in crisis, help is available 24 hours a day, seven days a week, by calling or texting 988, the Suicide and Crisis Lifeline.

Casie Sultana, clinical nurse leader for Trinity Health Grand Rapids, prioritizes patient well-being, emphasizing support and improvement over solely managing risks within the facility.

"We want to be someplace that people feel welcome to come to who are dealing with suicide," Sultana emphasized. "You feel so alone. It's a very lonely journey and we want people to come seek help and feel welcomed when they do that."

Susan Burchardt, clinical services manager at Trinity Grand Rapids, advised other hospitals considering a similar program to learn from organizations already using it.

Support for this reporting was provided by The Pew Charitable Trusts.


get more stories like this via email

Access to reduced-price medication is a necessity for many rural Missourians with low income.

Rep. Cindy O'Laughlin, R-Shelbina, the Senate Floor Leader, said Big Pharma is trying to confuse legislators with unrelated hot-button topics such as abortion access and illegal immigration in a last-ditch effort to stop the state from joining a program to force drugmakers to sell medicines at a discount.

"Appealing to nuclear topics, which really do not apply in this situation, is a disingenuous way to try to defeat a bill that is actually good for Missouri," O'Laughlin asserted.

O'Laughlin pointed out the program is transparent, and uses the tax money saved to help low-income families deal with chronic conditions such as diabetes.

The drugmakers object to the government forcing them to give significant discounts, arguing hospitals' and for-profit pharmacies' bottom lines, particularly those owned by pharmacy benefits managers, are being exploited. Nationally, 46% of contract pharmacy agreements involve pharmacies linked to the three largest benefits managers.

Rep. Tara Peters, R-Rolla, introduced the 340B contract pharmacy access billand said the lobbying is absurd.

"Federally, 340B program does not allow for abortion drugs," Peters stressed. "Why would any legislation that we're trying to pass in the state allow for that? I mean, the thought of that even being in existence is absolutely ludicrous."

The Missouri Senate passed the bill 27-3 on Monday and it now goes to the House.


get more stories like this via email