July 25, 2007 - Narcotic Renewals No Longer Available at Hospital

Today’s health care dynamics have created a new challenge in dealing with narcotics prescriptions in the emergency department.

Doctors find themselves struggling on a regular basis, balancing the genuine need for pain relief with the potential for drug abuse.

“Prescription drug abuse is a major public health hazard,” says Dr. Coulas, Chief of Staff at SFMH.

At the same time, she notes that narcotics are an essential instrument in the tool chest of modern health medicine.

“The bottom line is that narcotics require judicious use and vigorous monitoring which the emergency department is not capable of providing,” she explains. “Our job in the ER is to respond to immediate care needs. We have to leave the ongoing management of longer-term needs to another setting.”

Those factors have led the SFMH staff physicians to decide that they will only prescribe short-term pain medication when necessary for emergency use and long term narcotic prescriptions will not be renewed in the emergency setting.

“Writing those renewals is probably the worst thing we can do in terms of the overall good of our society,” Dr. Coulas comments, noting that the cultural use of prescription narcotics continues to rise and the street sale of prescription drugs is a documented problem.

“Normally, patients requiring long-term narcotic prescriptions for are expected to receive them from their family doctor and in a perfect world, everyone would have a primary physician and we wouldn’t face this dilemma”, Dr. Coulas says.

However, we recognize this is not a perfect world, so the medical staff has developed a procedure to screen patients requesting long term refills that requires testing and a return visits.

“We don’t want to raise unnecessary concerns,” comments Joan Kuiack, director of patient care services. “We understand that there are people who legitimately require these drugs to deal with chronic pain or long-term medical conditions.”

“Those people will receive the appropriate care,” she adds.

“This is a measure of caution that our physicians feel is necessary to prevent inappropriate abuse of the system.”

Reducing inappropriate use of the emergency department will also decrease the pressure on that part of the hospital system and allow the professionals there to focus on the care they are intended to provide.

Patients without a family doctor are advised to contact the Rainbow Valley Health Clinic in Killaloe for eligibility criteria and information on their walk-in clinic.

St. Francis also advises patients seeking a family physician to visit the College of Physicians and Surgeons of Ontario website at www.cpso.on.ca to access the “Doctor Search” service offered there.