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OR Emergency Docs Fight Prescription Drug Abuse

PHOTO: Dr. Sharon Meieran. Courtesy of Oregon Chapter, American College of Emergency Physicians.
PHOTO: Dr. Sharon Meieran. Courtesy of Oregon Chapter, American College of Emergency Physicians.
September 17, 2012

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.

Chris Thomas, Public News Service - OR