Yavapai Regional Medical Center’s (YRMC’s) Emergency Department (ED) implemented new guidelines for prescribing controlled substances on October 1. The new guidelines—developed to address prescription medication abuse—mirror the efforts of other Arizona hospital EDs and are part of a broader partnership with MATFORCE, a coalition dedicated to reducing substance abuse in Yavapai County.

“As caregivers, we’re extremely concerned about prescription drug abuse in our county, state and nation,” said Diane Drexler, RN, Chief Nursing Officer, YRMC. “These guidelines allow YRMC to provide the best care possible to all of our Emergency Department patients.”

The guidelines—developed by a team of YRMC ED physicians, nurses, social workers and administrative leaders in partnership with MATFORCE representatives demonstrate great concern for the health of the community, according to Sheila Polk, Yavapai County Attorney.

“It takes an entire community to address substance abuse issues. I admire, support and am so proud that YRMC stepped forward to be part of a solution that is truly going to make a huge difference,” Polk said.

YRMC’s new guidelines incorporate the following standards of care:

• Prescriptions for opioids (narcotics) to treat patients with chronic pain should come from a single provider. This means that YRMC’s ED will not prescribe narcotic pain medication after a patient’s initial ED visit or if the patient has received narcotic medications from another physician or ED.
• YRMC’s ED discourages giving opioids in intravenous (IV) form or as shots for acute pain. Shots to alleviate chronic pain are not given through the ED. YRMC’s ED does not prescribe Schedule 2 Controlled Substances for chronic pain as these medications are linked most frequently to abuse and addiction.
• Long-acting or controlled-release opioids, such as OxyContin, fentanyl patches or methadone, are not prescribed by YRMC’s ED. Methadone doses for people in methadone treatment programs are not administered by YRMC’s ED.
• Patients given prescriptions for controlled substances from YRMC’s ED may be asked to show a government-issued photo ID, like a driver’s license, at the hospital’s pharmacy. In order to track prescriptions for controlled substances, people who don’t have an official photo ID may be photographed for their medical record.
• YRMC does not refill stolen or lost prescriptions for narcotics or controlled substances.
• In keeping with the law and best medical practices, YRMC’s ED requests a patient’s medical records when providing treatment and also shares information about treatment administered in the ED with the patient’s physician or physicians.
• YRMC’s ED will establish care plans for frequent ED patients, which may include recommended strategies for avoiding medications associated with abuse or addiction.

According to Drexler, these new guidelines allow YRMC’s ED to maintain its unique and essential role in the community.

“Emergency departments are available 24 hours a day, seven days a week,” Drexler said. “They care for people facing the unexpected: the passengers injured in a car crash…the person who suffers a heart attack while jogging…the child who fractures his arm while playing at the park. We believe these guidelines for prescribing controlled substances allow us to continue fulfilling that important role and encourage people with chronic pain to work with the appropriate medical professionals to address their long-term health challenges.”

The Arizona Substance Abuse Partnership (ASAP) reported that more than 11 percent of Arizona adults surveyed said they had used prescription drugs without a doctor’s consent in 2010. Almost half of those had misused prescription drugs in the previous 12 months and 13 percent reported misuse in the past 30 days.