2015-02-06 / Front Page

County doctors impose stricter rules on Rx pills

Policy aims to curb abuse of painkillers
By Anna Bitong


NEW PAIN MEDICATION GUIDELINES—Dr. Celia Woods speaks about her hopes that the county’s new pain medication policies will save lives by preventing accidental overdoses. She spoke Jan. 29 during a press conference at Los Robles Hospital in Thousand Oaks. 
SUSAN WEININGER/Acorn Newspapers NEW PAIN MEDICATION GUIDELINES—Dr. Celia Woods speaks about her hopes that the county’s new pain medication policies will save lives by preventing accidental overdoses. She spoke Jan. 29 during a press conference at Los Robles Hospital in Thousand Oaks. SUSAN WEININGER/Acorn Newspapers A significant increase in the number of prescription drug overdose deaths in Ventura County has resulted in greater restrictions for prescribing pain medications in emergency rooms.

A new policy, already in place in San Diego and Los Angeles counties, was announced by county ER doctors at Los Robles Hospital and Medical Center in Thousand Oaks on Jan. 29.

Among the new rules: Doctors in the county’s eight emergency rooms will prescribe limited amounts of painkillers and will not refill lost or stolen prescriptions.

Doctors may also ask for a patient’s photo ID before prescribing medication.

In addition, county doctors will not prescribe long-acting pain medicines such as oxycodone, fentanyl and methadone.

“Emergency room physicians are seeing more and more people coming to ERs seeking pain medications for other reasons,” Celia Woods, medical director at Ventura County Behavioral Health, told the Acorn. “The hope is that the general community will see that the emergency room is a place to go to get emergency medical care. It’s not the place to go to get chronic pain medications prescribed because of lost prescriptions.”

Under the new policy, she said, ER doctors will not refill lost prescriptions from primary care doctors. Patients will need to refill prescriptions with the same doctor who gave the original prescription, Woods said.

In 2012, there were 103 drug and alcohol overdose deaths reported in the county, 46 of them caused by prescription drugs, including opiates such as Vicodin and Oxycontin. In 2013, there were 101 deaths caused by drugs and alcohol, 55 from prescription drugs, according to the Ventura County medical examiner’s office.

The use of opiates can also lead to heroin use. The majority of people who use heroin nowadays started with prescription medicine, Woods said.

Meanwhile, the number of pain medicine prescriptions has risen 150 percent since 1998, when doctors in the United States gave 109 million opiate prescriptions. In 2012, doctors wrote 259 million opiate prescriptions, Woods said.

The excess pills in medicine cabinets are often abused by young people. One out of five 11th-graders has misused a prescription medication, Woods said.

“There are a lot more medications sitting around,” she said. “Where there’s access, there’s a potential for misuse.”

In an effort to curb abuse of the drugs, ER doctors will be strongly encouraged to check the Controlled Substance Utilization Review and Evaluation System (CURES) database to see if patients have received prescriptions from more than one physician or were recently given multiple prescriptions, said Marty Ehrlich, medical director of the emergency department at Ventura County Medical Center Santa Paula Hospital.

“They should be getting their care under a single physician and exclusively getting prescriptions from that physician,” Ehrlich told the Acorn. “Anecdotally, (prescription drug abuse) has been a problem for a long time. The counties have taken a stance and are trying to standardize their approach to dealing with chronic pain.”

Carlo Reyes, vice chief of staff at Los Robles Hospital, said, “Whenever there is a patient coming in and the narcotic is requested or they have a history of the narcotic pain management, then we really need to engage the doctors who have been taking care of them.

“As long as all the doctors involved in the patient’s care are on the same page, then we can all agree on the safer treatment plan. That’s really one of the main purposes of the safe prescribing guidelines.”

Woods said the process can save lives.

“If patients are coming in seeking pain medications when those medications are not indicated for their health condition, that might be an opportunity for intervention,” she said. “A discussion then can occur with the individual that might lead to a more accurate determination of what their true treatment needs are—which might be a referral to a drug treatment program, as opposed to filling a prescription for an opiate.”

For help with substance abuse or addiction, call (805) 981-9200 for referral and treatment.

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