Doctors skeptical that ER opioid rule will help stem abuse
Maria Guyette sees the opioid epidemic up close but doesn’t think her fellow emergency doctors should be singled out by lawmakers in the effort to combat it.
Prescription drug-related emergency room visits doubled over six recent years, said the UPMC Shadyside doctor, who is presidentelect of the Pennsylvania College of Emergency Physicians. “That number has continued to increase, and these patients that are dying are dying at our doorsteps, which is heartbreaking,” she said.
So what does she think of a proposal approved in the House, and endorsed by Gov. Tom Wolf this week, to restrict the prescribing of opioids by emergency doctors?
“I think it will not stop almost any medication from hitting the street,” she said, because ERs are not big narcotics prescribers, adding that the “no-you-can’t-do-it [approach] means you can’t make exceptions.”
Harrisburg leaders want to prohibit emergency room doctors from prescribing more narcotics than a patient needs for one week, with few exceptions. They would also bar emergency room practitioners from refilling prescriptions for patients who claim their original prescriptions were lost, stolen or destroyed.
Rep. Rosemary Brown, R-East Stroudsburg, sponsored a bill including those provisions that passed the House in June and awaits a Senate vote. This week the Wolf administration identified the restriction of emergency room prescribing as one of four opioid-related actions the Legislature should prioritize this year. His office on Wednesday reiterated his support, saying in a statement: “Medical professionals, including emergency room physicians, play an absolutely critical role in battling the opioid epidemic.”
Doctors agreed that emergency room doctors usually prescribe only enough to get the patient through to a visit with a long-term physician. Some added that a rural patient with a broken bone may not be able to get an appointment with a specialist within a week.
“There’s always going to be some exceptions,” said John Gallagher, a Sharon gynecologist who has cared for opioid-addicted mothers, and chairs a statewide task force that has helped to write voluntary guidelines for opioid use. “We don’t feel that [elected officials] should be practicing medicine.”
Similarly, the Hospital and Healthsystem Association of Pennsylvania, in an email response, wrote that “policymakers must