Earlier this month, hospital emergency departments (ED) in New York City and Denver joined the growing number of EDs across the country in restricting access to prescription painkillers. 
On January 10, Mayor Michael Bloomberg announced that New York City’s 11 public hospitals will no longer prescribe more than three days’ worth of narcotic painkillers. The hospitals will also no longer dispense long-acting painkillers, including OxyContin, Fentanyl, and methadone, at all. Furthermore, EDs will no longer fill prescriptions for patients who claim their pills were stolen. The policy does not apply to the city’s private hospitals, but several plan to adopt them voluntarily. In Denver, many of the city’s EDs are voluntarily adopting similar restrictions in order to address the city’s prescription pill problem. According to a report from The National Survey on Drug Use and Health, Colorado is second only to Oregon when it comes to painkiller abuse. The report found that 6% of Coloradans 12 years and older used painkillers for a non-medical purpose in the past year. The national average is 4.6%. Washington and Utah have already adopted statewide painkiller restrictions. Washington state restrictions include:
On January 10, Mayor Michael Bloomberg announced that New York City’s 11 public hospitals will no longer prescribe more than three days’ worth of narcotic painkillers. The hospitals will also no longer dispense long-acting painkillers, including OxyContin, Fentanyl, and methadone, at all. Furthermore, EDs will no longer fill prescriptions for patients who claim their pills were stolen. The policy does not apply to the city’s private hospitals, but several plan to adopt them voluntarily. In Denver, many of the city’s EDs are voluntarily adopting similar restrictions in order to address the city’s prescription pill problem. According to a report from The National Survey on Drug Use and Health, Colorado is second only to Oregon when it comes to painkiller abuse. The report found that 6% of Coloradans 12 years and older used painkillers for a non-medical purpose in the past year. The national average is 4.6%. Washington and Utah have already adopted statewide painkiller restrictions. Washington state restrictions include:
- ED physicians and nurse practitioners treating flare-ups in chronic-pain patients should first contact that patient’s primary care providers.
- Prescriptions for acute pain, such as a broken bone, should not exceed 30 pills.
- Emergency patients should be screened for substance-abuse dangers before being prescribed opioid medication.
- Official picture IDs must be presented at pharmacies to pick up pain prescriptions.
- Reminders to all providers that while they must evaluate pain, laws do not require them to prescribe opioids if other measures could work.
The American College of Emergency Physicians (ACEP) has not developed an official position on the prescribing of painkillers in emergency rooms. In an interview with the New York Times, Dr. Alex Rosenau, president-elect of the ACEP, said he appreciated Mr. Bloomberg’s activism in the face of a serious public health problem, but he also said he has a problem with legislators encroaching on his ability to practice. “Here is my problem with legislative medicine. It prevents me from being a professional and using my judgment,” he said. What do you think?
