The Addiction Epidemic – Best Practices for Medical Providers
Every hospital and medical provider has the opportunity to have a profound impact on the current addiction epidemic (primarily opioid addiction) by showing a commitment in social responsibility, educating staff, patients and the public and modelling the appropriate response to individuals presenting with substance use disorder (SUD) in the appropriate manner and with the protocols in place to provide assistance. The recommendations presented below have been developed as best practices for hospitals and medical providers after countless surveys and firsthand accounts of experiences with medical providers.
- all staff regarding the science of SUDs.
- physicians regarding responsible prescribing.
- all staff regarding the signs of SUDs.
- all staff regarding appropriate response and communications with persons with SUDs.
- patients regarding personal responsibility to lock up prescriptions.
- the public regarding opioid addiction by displaying posters in prominent locations that outline the risks associated with narcotic painkillers.
Emergency Room/Overdose Treatment Protocols:
- Administer medications like Suboxone to relieve symptoms of withdrawal, with intent to taper.
- Perform an assessment of addiction treatment needs onsite after severe withdrawal symptoms have been reduced via medical treatment.
- Provide direct transfer to care or make follow-up appointments for patient.
- Request family or friend support contacts and obtain medical information releases.
- Provide informational session to support contacts regarding addiction, assessment performed, and potential outcomes.
- Discuss risks of overdose with patient and support contacts.
- Educate both patient and support contacts on use of Naloxone and provide a take home kit.
- If treatment is refused, provide referral numbers for treatment on discharge paperwork and assign a recovery advocate.
- Never discharge prior to 8 hours after Naloxone administration.
- If person is IV user, provide education on proper use (harm reduction) and provide clean needles on discharge.
- Provide safe sharps disposal box.
- Determine if children live in the home and engage CPS.
- Follow-up with person via phone the next day and offer treatment again.
- Create a self-reporting system for all prescribers within the hospital system to report how many prescriptions of narcotic painkillers they have prescribed. Hospital should review practices of top 30% prescribers.
All Patient Treatment Protocols:
- Perform Screening, Brief Intervention, and Referral to Treatment (SBIRT) with all patients.
- Ask patients regarding history of addiction and desire to avoid medications prior to prescribing.
- Teach all patients regarding risks of addiction to medications as well as importance of locking up prescriptions that can be abused.
- Require Physicians to check history of Emergency Room visits prior to any prescribing.
- Provide tamper and abuse deterrent painkillers.
Social Responsibility Response:
- Provide medical lock boxes at cost or free for those who are prescribed opiates, especially when used for long term care or chronic pain.
- Provide prescription mail back envelopes and information regarding safe disposal locations.
- Provide safe sharps disposal take home boxes for active users.
- Make substance use professionals available to staff 24/7 to respond to patient needs.
- Provide education to staff regarding seeking help for themselves and provide a safe way for them to do so.
- Provide prescription drop off boxes and sharps disposal access at all branch locations.
Truth Pharm will promote the providers that adopt Best Practices. Contact us and inform us of your efforts.