Description

In 2012, the state of Maine led the nation in prescriptions for opioids. According to the National Institute on Drug Abuse, from 1990-2010 unintended U.S. deaths caused by prescription opioid overdoses quadrupled, surpassing deaths involving heroin and cocaine. In that same time period, the annual number of opioid prescriptions almost doubled, rising from 120 to 210 million.

In 2011, prescription protocol guidelines were implemented in the emergency departments (ED) of Miles Memorial Hospital and St. Andrews Hospital, both located in the rural region of midcoast Maine. Together, they have a combined annual patient volume of roughly 17,000.

These guidelines are a one-page, easy-to-understand protocol utilized by physicians and nurses for evaluating patients complaining of pain. The overall goal is to deter patients who may be abusing prescription drugs or other illicit substances.

The guidelines recommend providers make a thorough effort to verify a patient's recent medication history, and also suggest a consideration to reduce or deny prescription refills for opioids allegedly lost or stolen.

In addition, providers are encouraged to avoid prescribing controlled substances to patients with a known history of taking these medications for pain management.

Disgruntled pain patients who are denied pain prescriptions often bring about lawsuits and complaints about inappropriate treatment. The guidelines served as official hospital policy, giving emergency room providers increased confidence in having their denial decisions supported by legal and hospital representatives.