Emergency Departments Unite to Combat Epidemic of Opioid Over-Prescribing and Avoidable Death

<0> Prescription Drug Abuse Medical Task Force Announces Los Angeles County-wide Plan </0>

Emergency Departments Unite to Combat Epidemic of Opioid Over-Prescribing and Avoidable Death

The Los Angeles County Prescription Drug Abuse Medical Task Force, a collaborative effort representing physician and nursing groups, hospital associations, and public health and community clinic representatives, announced today that emergency departments (EDs) across Los Angeles County are implementing standardized clinical guidelines for the safe prescribing of opioid pain medications to combat a national epidemic of opioid over-prescribing, misuse, overdose, and death, and to mitigate doctor and ED shopping for prescription pain medications.

Seventy-five (75) hospital emergency departments throughout Los Angeles County serving adults, including Los Angeles County public hospitals, Kaiser Permanente, Providence Health & Services, UCLA Health, Dignity Health, Daughters of Charity Hospitals, and other hospital EDs, including those served by Emergent Medical Associates (EMA), are rolling out standardized treatment and opioid prescribing practices, derived from the American Academy of Emergency Medicine (AAEM) guidelines and adopted by the California Chapter of the American College of Emergency Physicians (Cal-ACEP). This initiative across Los Angeles County follows in the footsteps of a similar effort in San Diego and Imperial Counties.

“According to the CDC, there is a national epidemic of prescription opioid abuse that takes about 16,000 lives each year in the U.S.,” said Jeffrey D. Gunzenhauser, MD, MPH, interim health officer, Los Angeles County Department of Public Health. “And we know that in Los Angeles County in 2013, there were nearly 400 lives lost due to prescription opioid overuse. Nationally, deaths from prescription opioids are greater than those from motor vehicle accidents each year, and greater than deaths from heroin, cocaine, and benzodiazepine drugs combined each year.”

“We also believe that these new safe prescribing guidelines will ensure that patients are prescribed appropriate medications by their physicians and will also reinforce standardized opioid prescribing practices in all emergency departments. The goal is to avoid high risk opioid over-prescribing and to mitigate opioid pain medication overuse, overdose, diversion, and doctor and ED shopping,” noted Maureen McCollough, MD, Los Angeles County Department of Health Services, Olive View-UCLA Medical Center, Emergency Medicine, and member of the California Chapter, American College of Emergency Physicians (Cal-ACEP), which is sponsoring this initiative statewide.

Some of the prescribing practices in the guidelines include:

“Long-term daily opioid use of 90 days or more is no longer considered good clinical practice for non-cancer pain,” said Joel Hyatt, MD, emeritus assistant regional medical director for Kaiser Permanente Southern California Region. “Recent clinical evidence supports use of opioids for short-term moderate to severe pain. These clinical guidelines directly address the over-prescribing of high risk prescription opioids, misuse, and diversion, e.g., prescriptions left in medicine cabinets that are commonly used or sold by family or friends, including children.”

Kaiser Permanente provided a community benefit grant to fund printing and distribution of an initial two months’ supply of patient information handouts for the 75 EDs across Los Angeles County, i.e., more than 386,000 handouts to be used to educate and inform patients and consumers at discharge after ED visits.

The Los Angeles County Prescription Drug Abuse Medical Task Force includes the Los Angeles County Departments of Public Health and Health Services, Cal-ACEP, the Hospital Association of Southern California, Kaiser Permanente, the Los Angeles County Medical Association (LACMA), the California Emergency Nurses Association (CENA), the Community Clinic Association of LA County (CCALAC), and the San Diego Prescription Drug Abuse Task Force.

“This task force is uniting with physicians and emergency department staff, providing them the tools and guidelines that will help them communicate these practices to all patients and consumers. These are prescribing practices that can save lives, and spare families the heartache of losing their loved ones,” said Pedram Salimpour, MD, President of the Los Angeles County Medical Association. “When patients turn to the ED for pain management, the task force guidelines, applied consistently, can be part of the solution to combat opioid medication overuse, abuse, and doctor shopping.”

For more information on the work of the Task Force, go to: .

Kaiser Permanente is committed to helping shape the future of health care. We are recognized as one of America’s leading health care providers and not-for-profit health plans. Founded in 1945, our mission is to provide high quality, affordable health care services to improve the health of our members and the communities we serve. We currently serve more than 3.8 million members in Southern California. Care for members and patients is focused on their total health and guided by their personal physicians, specialists, and team of caregivers. Our expert and caring medical teams are empowered and supported by industry-leading technology advances and tools for health promotion, disease prevention, state-of-the-art care delivery, and world-class chronic disease management. Kaiser Permanente is dedicated to care innovations, clinical research, health education, and the support of community health. For more information follow us on Twitter: , or go to: .

The Department of Public Health is committed to protecting and improving the health of the nearly 10 million residents of Los Angeles County. Through a variety of programs, community partnerships, and services, Public Health oversees environmental health, disease control, and community and family health. Public Health comprises nearly 4,000 employees and has an annual budget exceeding $900 million. To learn more about Public Health and the work we do please visit , visit our YouTube channel at , find us on Facebook at , or follow us on Twitter: @LAPublicHealth.