How norman regional is addressing the opioid crisis news normantranscript.com pain chest and back

Ball said people come in who present chronic pain and exacerbation of chronic pain. With a policy in place, ER doctors can explain they don’t write prescriptions for this type of pain out of the emergency room. Those people need to work with private doctors and pain specialists.

“People who were prescribed one day of pain medicine in the ER, 6 percent of those people at one year were still taking opioid pain medication,” he said. “If those people received eight days worth of medication, it was 13 percent at one year who were still taking them. Thirty days and the number goes up over 30 percent.”

Nationally, there has been an increase in emergency room visits and hospitalizations due to opioids, Foster said. Another trend is an increase in babies born addicted, most of whom end up in a Neonatal Intensive Care Unit (NICU).


Consistent with the national trend, the HealthPlex NICU has experienced an increase in babies born addicted to opioids, said Interim CNO Brittni McGill, who also serves on the committee.

In 2016, the Centers for Disease Control and Prevention (CDC) released guidelines for prescribing opioids for chronic pain. In March 2017, the President Donald Trump declared the opioid crisis a national public health emergency and created “The President’s Commission on Combatting Drug Addiction and the Opioid Crisis.”

That commission recommended including that questions on pain management be removed from patient surveys used by the Centers for Medicare and Medicaid Services (CMS) to measure hospital performance. Those measurements are directly linked to financial incentives and penalties, meaning if patients answered that they were in pain during their stay, hospitals were potentially penalized for low patient satisfaction, meaning they were literally incentivized to administer more pain medication.

Norman Regional also has a multidisciplinary, system-wide drug monitoring program to prevent drug thefts. Foster said program is “very robust” in tracking and accounting for drugs administered at NRHS hospitals and facilities. That includes checking drugs at every step along the way, even checking drugs turned in for disposal to make sure they are what they are supposed to be.

“What we quickly realized when reviewing our systemwide pain policy is it was really heavily geared toward medication intervention and not so much toward those non-pharmalogical interventions such as imagery or massage or breathing techniques,” McGill said. “We really need to change our focus to what we want it to be.”

Illegal importation is certainly a problem. On Feb. 9, 33 pounds of fentanyl was seized in Boston from the Mexican Sinaloa Cartel. In its raw form, that’s enough fentanyl to kill 7 million people, Foster told the Norman Regional Hospital Authority on Monday.

To combat the marketing issue, lawsuits have been filed across the nation, like the one Oklahoma Attorney General Mike Hunter filed against Purdue Pharma and other pharmaceutical companies, alleging that marketing played down or denied the addictive nature of opioids, presenting them as the cure to human suffering through pain elimination.

In 1996, time-released oxycodone (OxyContin) was touted as having a low risk for addiction by its maker, Purdue Pharma. Purdue Pharma was founded in 1892, but in the 1950s three brothers, Arthur, Mortimer and Raymond Sackler, bought the company, according to multiple sources.

In response to this article as originally published, Purdue Pharma has clarified that, Recent news coverage has wrongly characterized the relationship between Dr. Arthur M. Sackler and Purdue Pharma L.P., the company founded four years after his death by his brothers, Drs. Mortimer and Raymond Sackler. OxyContin was brought to market nine years after Arthur’s death and neither he nor any of his descendants have ever had any involvement or financial stake in its success. Dr. Arthur M. Sackler was never involved in any way in the invention, research, development, business or marketing or any other activities of Purdue Pharma L.P. or of OxyContin.

That same type of marketing genius was used to promote Purdue Pharma’s OxyContin which was approved by the government in 1995 and released for use by Americans in 1996, according to the Federal Drug Administration. OxyContin was the first formulation of oxycodone that allowed dosing every 12 hours instead of every four to six hours because of its time-release formula.

“At the time of OxyContin’s approval, FDA product labeling warned of the danger of abuse of the drug and that crushing a controlled-release tablet followed by intravenous injection could result in a lethal overdose,” the FDA states. “There was no evidence to suggest at the time that crushing the controlled-release capsule followed by oral ingestion or snorting would become widespread and lead to a high level of abuse.”

To improve pain management, the “Pain as the 5th Vital Sign” initiative required a pain intensity rating (0 to 10) at clinical encounters, measuring and tracking pain along with blood pressure, heart rate, respiratory rate and temperature as vital signs within a patient’s record based on patient feedback, according to the National Institutes of Health.

“In clinical practice, pain as the fifth vital sign has proven to be more complex to assess, evaluate, and manage than originally anticipated. It has also had some serious consequences which were never intended. Associated with the national push to adequately manage patients in pain has been a rise in prescription opioids as well as a rise in opioid related death,” Dr. Natalia E. Morone and Dr. Debra K. Weiner wrote in their study, “Pain as the 5th Vital Sign: Exposing the Vital Need for Pain Education.”