In response to the nation’s opioid crisis, Baylor Scott &White Fort Worth's emergency department is among a growing number across the country choosing to reduce their use of opioids to manage pain.
Dr. Toral Bhakta is medical director of the emergency department at Baylor Scott &White Fort Worth. She says research has shown emergency rooms have played a role in opioid dependency.
INTERVIEW HIGHLIGHTS:
Emergency departments and opioid use: “There has been significant data that shows that patients given opioids for acute pain management only within seven days of use develop long term usage from opioids. About six percent of patients only develop long term usage after just one single dosage prescribed from the E-D (emergency department). Studies have shown the E-D really is the starting point for dependence to opioids because of the usage that we have in the past decade.”
Were opioids always necessary: "Over the past few decades, public policies, as well intended as they were, really pushed for managing our patients’ pain and comfort. Now that we have recognized the harm that is causing, the medical community has taken action to use alternative methods such as acetaminophen, Motrin, other NSAIDs. We can also do trigger point injections and nerve blocks. Other medications such as lidocaine and ketamine."
Why this wasn’t done before: “Part of the reason was just a growing awareness. Also, just public policies that asked the medical community to make people comfortable, but growing awareness of the epidemic has really led the medical community to deviate from that and start using non-narcotic methods.”
Current use of opioids: “We still use opioids in our emergency department, but not as first line therapy. We aim to manage pain in our department with non-narcotic medication as a first line. In cases of severe pain when other pain medicines do not provide the desired analgesic effect is when we resort to opioids.”
RESOURCES:
These 10 ERs Sharply Reduced Opioid Use And Still Eased Pain
Drug Seeking or Pain Crisis? Responsible Prescribing of Opioids in the Emergency Department
