Hospitals Retraining Staff To Reduce Opioid Prescriptions

Opioid prescriptions

A growing number of hospitals across the country are rewriting protocols and retraining staff in an effort to minimize opioid prescriptions, PBS NewsHour reports. The changes are most pronounced in emergency departments.

At the University of Kentucky Albert B. Chandler Hospital, emergency room doctors used to give opioid painkillers right away. Dr. Phillip Chang, the hospital’s chief medical officer, says now doctors, pharmacists and nurses use non-opioid pain relievers like Advil or Tylenol first. They try multiple regimens before considering opioids.

In a study of 900 patients treated at the hospital after the new policies were implemented, the trauma unit almost halved the amount of opioids given to patients who had no prior history of chronic opioid use. But there was little change in prescriptions for patients who were already chronically using opioids before admission. The hospital is now training ER doctors to prescribe fewer opioids for drug-dependent patients, and guiding them toward substance abuse treatment when they leave the hospital.

“Patients say, ‘Doc, I want the strongest thing you’ve got,’” said Dr. Daniel del Portal, an assistant professor of clinical emergency medicine at Temple University in Philadelphia. “But patients don’t always understand the risk the strongest pain medicine can create. Patients don’t appreciate that until it’s too late.”

At the UK hospital in Lexington, Ky., Chang said the philosophy used to be to give an opioid painkiller right off the bat. And then, he said, “we’d just give more of it.” Slowly, he got doctors, pharmacists, and nurses on board with using non-opioid pain relievers like Advil or Tylenol first, and trying multiple regimens before finally considering something stronger. He also trained them on how to explain the shift to patients.

“Sometimes it’s impossible to bring pain to zero,” Chang said. “But we’re trying to make it tolerable.”