Emergency rooms adopt opioid standards

Seventy-five hospital emergency departments throughout Los Angeles County are rolling out standardized treatment and opioid prescribing practices, derived from the American Academy of Emergency Medicine guidelines and adopted by the California Chapter of the American College of Emergency Physicians. This initiative across Los Angeles County follows in the footsteps of a similar effort in two nearby counties.

“We know that in Los Angeles County in 2013, there were nearly 400 lives lost due to prescription opioid overuse. Nationally, deaths from prescription opioids are greater than those from motor vehicle accidents each year, and greater than deaths from heroin, cocaine, and benzodiazepine drugs combined each year.” said Jeffrey D. Gunzenhauser, MD, MPH, interim health officer, Los Angeles County Department of Public Health, in a statement.

The goal is to avoid high risk opioid over-prescribing and to mitigate opioid pain medication overuse, overdose, diversion and doctor shopping.

Participants include public hospitals, Kaiser Permanente, Providence Health & Services, UCLA Health, Dignity Health, Daughters of Charity Hospitals, and other hospitals.

Some of the prescribing practices in the guidelines include:

• Use opioid medications as a last resort and only for severe non-cancer pain at the lowest possible doses
• Avoiding intravenous or injectable opioids in patients who are already taking chronic opioid medications
• ED physicians will not replace “lost” or “stolen” opioid prescriptions
• ED physicians will only prescribe a limited days’ supply
• Promote one prescriber and one pharmacy for pain medication treatment
• Use of the State of California database

Kaiser Permanente provided a community benefit grant to fund printing and distribution of an initial 386,000 handouts to be used to educate and inform patients and consumers at discharge after ED visits.

For more information on the work of the county’s task force, go to: https://www.lacmanet.org/advocacy/safe-prescribing.aspx.