SAMPSON REGIONAL PUTS AN END TO DISPENSING OF NARCOTIC PAIN MEDS

In an effort to reduce the epidemic of prescription drug abuse being
felt in Sampson and across the country, emergency physicians at
Sampson Regional Medical Center are no longer refilling narcotic pain
and sedative medications. Instead of dispensing narcotic pills, they
are instead doling out referrals to primary care physicians so
patients may receive the proper treatment.

Sampson Regional is another in the growing number of emergency
departments taking such measures to reduce the increasing overuse of
narcotic and sedative medications used to treat chronic pain.

Medications such as Codeine, Hydrocodone (Lortab and Vicodin),
Oxycodone (Percocet), Morphine, Darvocet, Oxycontin, Xanax and Valium
are just some that will no longer be dispensed by emergency
physicians. A full list is provided by hospital officials.

"We are trying to limit the amount of narcotics being given out,"
said Dr. Steven D. Kelley, chief of emergency medicine at Sampson Regional.

He pointed to the increasing abuse of the medications.

"It seems as though that has become more of a problem," said Kelley.
"What they were doing previous to this policy was (patients) were
given four or five pills to get them through."

Those pre-packs of narcotic pills were given out after pharmacy hours
so pain could be eased in the meantime.

"What's happening is people are getting narcotics from multiple
providers," said Kelley. "People have implemented other policies to
limit the use and abuse of narcotics. It is becoming sort of an epidemic."

Under the new policy, implemented Feb. 1, patients who have chronic
pain will only receive non-narcotic pain medication as a temporary
treatment. Patients who frequently visit the emergency room seeking
relief from pain -- more than two visits in one month, six visits per
year -- will be deemed to have chronic pain syndrome.

The policy makes exceptions for terminal conditions, such as cancer.
However, all patients will be responsible for maintaining an active
prescription with their primary care provider.

"The goal is to get them back to a primary care physician," said
Kelley. "Our goal is to get these folks who frequent our ER the
proper care. We need to get them to someone to manage that care and
that's not what the ER is there to do. We manage emergency care."

Wanda Boyette, chief operating officer at Sampson Regional, said the
SRMC emergency room remains inundated with patients receiving all
levels of care, estimating well in excess of 30,000 patients a year.

"It's increasing, it's definitely not decreasing," Boyette noted.

She said there may be some backlash as a result of the new policy,
but patients are urged not to take it up with emergency physicians.
They are all required to follow the policy, which has been adopted
after consideration by the Emergency Department Staff, as well as
endorsements by the hospital's medical staff and the hospital administration.

"We'll have more complaints," said Boyette. "They'll be angry and
take it out on providers. It will not be without a lot of gnashing of
teeth. We want to take care of their pain, but we will not be
dispensing narcotics, so they know what to expect. You just don't
come to the ER to get narcotics and get refills. We want to give them
the proper care."

Boyette said, once confronted with the policy, patients may show
hostility and then seek the narcotic medications from elsewhere. She
said she is hoping they will grow to accept the change and form a
closer relationship with their primary care provider so that plans to
treat chronic pain can be developed.

Laurie Smith, director for emergency services at SRMC, said the
policy must be followed and all nurses have been instructed to do so.

"We probably will be in the hot seat," said Smith. "On behalf of the
nursing staff, I just want to make sure the policy is followed. We
don't want to add to the epidemic."

In the past, some patients have gone so far as to return to the
emergency room under fictitious names, in an effort to get more
narcotic medications.

"As a nurse, you know this patient is being dishonest but there's not
much you can do," said Smith. "(The new policy) standardizes the care."

Kelley said the most important thing everyone should know is that if
they are experiencing pain, doctors at Sampson Regional will do their
best to ease it -- in a responsible way. Patient safety is at the
forefront, Boyette said.

Boyette noted two recent deaths at Sampson Regional from patients
taking narcotic medications. They were not given the meds at the
Clinton hospital, but died as a result of them.

"That should hit home with people around here that these narcotics
can be dangerous," said Kelley. "You see people getting excess
amounts and people taking too much narcotics for chronic pain.
Obviously, these medicines are important and needed, but there's a
better way to address chronic pain.

"It's much easier to write (the prescription) and move on," Kelley
attests, "but it's not the responsible thing to do."