Doctors are on the front lines of the drug epidemic as addicts often seek legal prescriptions, before searching for illegal alternatives like hard street drugs. For addicts, pain clinics and emergency room visits are often some of the fastest ways to acquire prescriptions for some of the most potent pain medication, without going through illegal channels. We’ve heard of addicts desperate for opioid pain medications actually inducing pain through self-harm, like crushing their hand with a hammer. (Yes, I’ve actually heard of this happening.)
However, at St. Joseph’s Regional Medical Center, located in Patterson, New Jersey, if you come with the hopes of receiving pain medication, there is a very good chance you may not leave with what you came for. At St. Josephs, doctors are now prescribing alternative, non-narcotic medications to patients as well as incorporating alternative therapies to help manage a patient’s pain level such as these:
- For kidney stones, a patient may receive IV doses of a non-opioid pain medicine such as lidocaine, which provides relief and often tides them over until the stone passes.
- For other types of acute pain, doctors will often use an ultrasound-guided injection of a nerve block that numbs the area much in the way Novocaine is used by dentists.
- Still other ailments may be treated with physical therapy or psychiatric counseling in addition to Tylenol or versions of Motrin.
So How Are They Choosing Who Gets What?
One-in-four people will be prescribed opioid pain medications, and during the first two months of this new change in prescribing, over three-fourths of patients were able to manage their pain without the use of narcotic pain relievers. Those who do receive pain medication must have the medical necessity for obtaining prescriptions to addictive pain medications.
With so much success surrounding the hospital’s new policy, many are wondering how this will impact the addicts in the area. The most common painkillers prescribed in doctors offices and hospitals are Oxycodone, Vicodin, and Percocet. According to Dr. Mark Rosenberg, Emergency Department Chair at St. Joseph’s Regional Medical Center, “Our job here together is to look at the whole equation and understand how we can stop people from going from a prescription to an addiction.”
While addiction and prescribing pain medication go hand in hand, doctors are working around the clock to try to stop the source of chronic pain symptoms before they start. Dr. Mark Rosenberg, chairman of Emergency Medicine at St. Joseph’s agreed that “opioids have their place in pain management… We know two things to be true: All chronic pain starts with acute pain. And all addiction starts with the first dose…So if we can stop [the] acute pain from becoming chronic pain, and if we never gave an opioid, no one would become addicted.”
So Where Does the Problem Stem From?
From pain clinics to hospitals, prescription pain killers seem to be given out like candy canes at Christmas time. While there are cases that prove medical necessity for pain medication to be prescribed, doctors at St. Joseph’s are trying to steer patients away from medications that are easily abusable. A few months ago the FDA and the CDC worked hard to encourage drug manufacturers to produce pain medications that are difficult to abuse both physically and chemically. As of April 2016, studies showed that drug overdoses involving both legal and illegal drugs surpassed traffic accidents as the leading cause of death nationwide.
While pain medication can be used responsibly by many, it is absolutely one of the easiest drugs to become addicted to. Furthermore, it can lead to life-threatening symptoms of overdose very easily, and can become a gateway drug for heroin. While doctors do believe that there are alternatives, they also want to ensure that they are acting in good faith and upholding their oath to take care of patients to the best of their ability. This means that in some cases, opioids will be prescribed, but on a smaller scale. Doctors fear that their patients may become severely addicted and at their hands, but it is a double edge sword.
“Opioids should be available, but they shouldn’t be the only thing we give…We see a lot of opioid addiction in the ER, unfortunately, so I thought we could try to curb some of the problems here.” Alexis La Pietra, Director of Pain Management, St. Josephs
For now, the results of this life changing policy are still out. The hospital representatives are hopeful that in limiting the availability of pain medications it could help combat the opioid epidemic in New Jersey.