Inova hospitals continue to fight opioid epidemic with E.R. opioid-reduction initiatives
Curbing an Epidemic
Emergency rooms take steps to reduce opioid use
The statistics are staggering. According to the Centers for Disease Control and Prevention, every day, 91 Americans die from an opioid overdose. And this number continues to rise.
To help deter opioid addiction in our community, the Emergency Departments (EDs) of Inova Mount Vernon Hospital and Inova HealthPlex – Lorton have joined Inova’s other hospitals in taking actions to reduce opioid use both in the emergency setting and after a patient has been discharged.
“We know there is a national and local crisis with opioid overdoses,” says Rett Embrey, MD, FACEP, Inova Mount Vernon ED Medical Director. “Evidence has shown that first exposure to opiates sometimes occurs at a hospital or during an ED visit. Beginning in 2016, we began to try to decrease exposure whenever possible while still being mindful of adequately addressing our patients’ pain needs.”
Opioid reduction initiatives involve educating hospital personnel about alternative medications that may be effectively used in the place of narcotics, monitoring opioid prescriptions through a state database, educating patients and families about their pain management options, and providing a continuum of care to resolve each patient’s pain issues.
Inova is targeting pain, while keeping a watch on opioid use
In addition to these initiatives, the Inova Mount Vernon and Lorton clinical teams are engaged in a number of other strategies that are proving to be effective at both adequately managing each patient’s pain and reducing opioid use. These include a program called “D-Lite,” which lessens the use of the powerful narcotic Dilaudid (hydromorphone), replacing it with effective non-narcotic medications; use of nitrous oxide as a non-narcotic pain relief medication; and even the use of virtual reality in the ED as a distraction from episodic pain related to specific procedures.
“In general, we’re moving away from highly potent, fast-acting, long-lasting medications that have a euphoric effect to other medications that are shorter-acting – to more safely control the painful episode for the patient,” explains Dr. Embrey. “We’ve seen a substantial reduction in the use of particular opioid medications that have been found to lean more toward potential addiction in vulnerable patients. Our goal has always been to treat pain safely, effectively and compassionately – but also judiciously – without putting patients at an increased risk for abuse or addiction. We remain committed to the excellent care of our patients and to managing their pain appropriately.”
Helping avoid opioid abuse after the Emergency Room
To ensure pain continues to be well-controlled, Inova’s Mount Vernon and Lorton teams connect chronic pain emergency patients with a variety of medical specialists. “We have a robust program with on-call medical specialists who can help us manage a patient’s painful condition or injury. This includes developing a plan for pain control moving forward,” says Dr. Embrey.” Once a patient is discharged from the ED, emergency personnel prescribe non-narcotic medications as a first-line treatment when appropriate. The new protocol is designed to limit the number of opioid prescriptions.
“As a nation, we have much more to do,” Dr. Embrey continues. “But already we are making a difference in the communities we serve.”
Excellence in emergency care for Northern Virginia
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