Healthcare News & Insights

Avoid prescription drug abuse in ED patients

It’s a big problem: Patients visiting the emergency department (ED) seeking prescriptions for painkillers so they can feed a drug addiction. Hospitals have had trouble cracking down on this phenomenon in the past, but facilities in several states have come up with effective solutions. 

Hospital WorkerMany patients who visit the ED for the sole purpose of accessing prescription drugs such as Percocet, Oxycodone and Vicodin are “superutilizers,” averaging multiple visits in a month. And this can be costly to hospitals.

According to an article published on NPR, pill-seekers flooded the ED after many states created tracking systems that let doctors in primary care practices and clinics look up the history of patients with suspicious requests for narcotics and other drugs.

While ED doctors have access to this info, it’s often difficult to review every patient who may be abusing the system because of the hectic nature of emergency medicine. So addicts find it easier to visit the ED since their suspicious behavior tends to fall through the cracks.

Successful programs

To make rooting out these issues easier, hospitals in several states, including Texas, Wyoming and New Mexico, have created their own tracking systems tailored specifically to the ED environment.

In Wyoming, for example, Cheyenne Regional Medical Center has customized its electronic health records (EHR) system so that people who could be abusing the system have bold red letters on their record stating they may be doing so.

And because even a habitual user may need prescription drugs every once in a while for certain conditions, the decision to “cut off” a patient isn’t always made during a hospital visit. Cheyenne Regional has created a special panel of hospital administrators and doctors that meets once every month to decide if patients flagged for this behavior should be labeled as actual drug abusers.

If the panel finds evidence of drug abuse (such as multiple visits to the ED in a month that resulted in a prescription for painkillers), the hospital will mail a certified letter to the patient’s address saying the only way they’ll receive these drugs going forward is in a life-threatening emergency.

A similar program in place at San Juan Regional Hospital in New Mexico has had long-lasting positive effects. Screening patients for patterns associated with drug abuse cut visits to the emergency department by 5% in just one year. And the hospital also saved close to $500,000, since most of these patients were also uninsured.

Getting started

Because some patients truly do need the services provided in the emergency department, including prescriptions for painkillers, doctors must tread carefully when it comes to suspected addiction, looking at each patient on a case-by-case basis.

But having a program in place where healthcare executives and providers evaluate ED visits after the fact may help identify patients who’ve been abusing the system without denying them the care they need.

To that end, you may want to ask your EHR vendor if there’s any way to customize your system to flag these behavior patterns so medical records can be reviewed easily later on.

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