Yampa Valley Medical Center joining pilot program to reduce opioid use in emergency rooms
May 17, 2017
Steamboat Springs — As an emergency room physician for more than 30 years, Dr. David Wilkinson is used to seeing people come though the doors at the Yampa Valley Medical Center in pain.
"We see pain,” Wilkinson said. “It's the number one reason people come into the emergency room.”
In many cases, Wilkinson said opioid-based painkillers are administered, in small quantities, to help those patients deal with the immediate pain. Wilkinson said the reason those painkillers are prescribed in small doses is so that patients will need to return to him or see another physician for a follow-up visit to evaluate the continued use of opioids and explore alternatives.
But with an epidemic of opioid abuse sweeping across the U.S., hospitals are looking at ways to cut down on opioid use and limit exposure to the highly addictive painkillers.
The Yampa Valley Medical Center in Steamboat Springs will be participating in the Colorado Opioid Safety Program to reduce the use of opioids in Colorado emergency departments through the implementation of new guidelines.
"The goal is pretty straight forward; we want to cut the use of narcotics and opioids by 15 percent," Wilkinson said. "It's an entirely achievable goal. Of course, we have to acknowledge that the use of narcotics and opioids for acute short-term management of pain will always have some role in pain management, but there are alternatives that you can use for long-term management."
The six-month pilot program is a collaboration between the Colorado Hospital Association and its partners, the Colorado American College of Emergency Physicians, the Colorado Consortium for Prescription Drug Abuse, Telligen — Colorado's quality improvement organization — and the Colorado Emergency Nurses Association.
YVMC is one of eight Colorado healthcare facilities participating in the pilot program.
"What we hope to expect is that people's pain is treated just as well as it is currently is being treated without using opioids," said Wes Hunter, YVMC’s director of pharmacy and president of the Colorado State Board of Pharmacy.
He said patients may see a change in the hospital's approach to treating pain.
"Generally, when you go to the emergency room with some sort of pain, you almost always expect to get some sort of narcotic pain reliever," Hunter said. "What we are trying to do is find alternatives, effective alternatives, to that. If we are not alleviating people's pain as well as what the opioids were doing then that's really a deal breaker."
Hunter said drugs like Lidocaine and Ketamine will be used in the emergency room in place of opioids.
"Ketamines have been used traditionally as an anesthetic agent,” Hunter explained. “Studies have shown some very promising results with some very low doses being used to treat pain very effectively without the adverse of events of a narcotic."
The program will also explore more natural remedies including massage, which can treat more severe pain at the source instead of automatically turning to a systemic opioid.
"We can use local anesthetics that block the pain at the source versus a systemic opioid that acts in your brain to decrease the pain sensation," Hunter said. "If the patient is not feeling that pain then they don't need to take an opioid.
According to the Colorado Hospital Association, Colorado is at the center of the nation’s opioid epidemic, with the 12th highest race of misuse and abuse of prescription opioids across all 50 states.
Hunter said that the Colorado Hospital Association is hoping the model being used in the pilot program will eventually be implemented in emergency rooms across the state.
"We’re trying to see if this is something that should be rolled out as a best practice statewide," Hunter said. “Hopefully, this will get published on a national level as well."