Hospital Happenings – April 2019

Pain in the Emergency Department

Pain is one of the most common reasons that people come to an Emergency Department in the United States. In the past, opioids have been used as the primary way to treat acute pain in the ED. More current studies have found that opioid pain medications are not only ineffective for some patients but have a high incidence of side effects and adverse reactions. With this information in mind, the Emergency Department physicians at Montrose Memorial Hospital are transitioning to alternative, evidence-based treatments, as their first line approach to treating patients with acute pain who present to the emergency department.

Opioids are a class or drugs that are naturally found in the opium poppy plant. According to the website, opioids are often used as medicines because they contain chemicals that relax the body and can relieve pain. They can also make people feel very relaxed and “high” which is why they are sometimes used as drugs of abuse and non-medical reasons. This can be dangerous because opioids can be highly addictive, and overdoses and death are common. Heroin is one of the world’s most dangerous opioids and is never used as medicine in the United States, but it is in the same class of opioids that are commonly prescribed for pain, highlighting the potentially addictive and dangerous effects of these prevalent medications. Common prescription opioids include Vicodin®, OxyContin®, Percocet®, codeine and fentanyl.

As patients come to the Emergency Department with pain, their symptoms will be individually assessed by the physician and nursing staff, and all physicians will follow a standardized approach for alternative treatment plans as appropriate. The goals are to limit opioid use, use alternative to opioids (ALTOs) for the treatment of pain, and implementing harm reduction strategies. Some of these alternatives include Ibuprofen, Acetaminophen (Tylenol), other non-opioid medications, trigger point injections, physical therapy, exercise, and relaxation therapy. Alternatives to Opioids will be discussed with each patient to see what the best option and course of therapy is.

Our goal is to improve pain management for our patients and return them to a maximum quality of life while also recognizing and minimizing the inherent risks of prescribing highly addictive and potentially dangerous medications. The ED providers are dedicated to understanding and appropriately responding to their patients’ physical and emotional symptoms of pain in addition to taking steps to help our community combat the ongoing opioid epidemic.

When prescribed to you, it is also important to properly discard unwanted, expired and unused medications, particularly opioid pain medications. THE BOX is a big, green disposal box that is secured in the hospital’s Emergency Department lobby and is available to the public 24/7. It is a safe, secure and compliant way to dispose of unused medications and keep them out of the hands of others. Studies demonstrate that a majority of abused drugs are acquired from family and friends.

MMH is committed to providing the best quality and safest care for our patients. In addition, we recognize opioid use and misuse is a high priority for our patients and the communities we serve, and we will do all we can to help our Friends and Family during their most vulnerable times.

Leann Tobin, Senior Director of Community Engagement, MMH 240-7344