With prescription drug abuse on the rise nationwide, hospital emergency departments (EDs) are looking for methods to better track and stop patients who demonstrate drug-seeking behaviors.
As we discussed in an earlier post on this issue, these “drug shoppers” not only pose a serious threat to themselves, but to legitimate patients in the ED, often causing increased wait times and distracted staff.
Though steps are being taken to spot and prevent drug shopping behaviors, it can often be a challenging process of trial and error. With an estimated 44 deaths a day in the United States from prescription drug overdoses according to an NPR story, it’s a crucial issue that healthcare providers can’t afford to ignore.
Initial Attempts to Stop Drug Shoppers
The first methods used to track prescription drug seekers involved faxing a warning to other area hospitals that the shopper was active. Local pharmacies were later added to this distribution list, and they too began to look out for offenders looking to fill the scripts. Following a fax, some EDs would mark the medical records of those suspected of drug shopping, adding local police to the distribution.
HIPAA fears put a stop to this information sharing, when hospital attorneys felt the liability was too great to continue the fax program. Despite the success of the program in preventing drug shopping, the potential violation to patient privacy ultimately trumped other issues.
New Approaches for the ED
Nearly every state currently makes use of a tracking system that allows doctors to look up a patient’s prescription history for regular office visits. However, until recently, EDs were without a similar system tailored to their needs. Now, several states, including Texas, Wyoming and New Mexico, have developed tracking systems specifically designed for the emergency room.
These tracking systems coordinate with a hospital’s electronic medical records, making it easier to spot potential shoppers. Some facilities use a bright red indicator on the records of repeat offenders. However, the fast-paced environment of a typical ED makes it difficult to consistently track abusive patients, even with the aid of monitoring systems. Often, doctors and nurses don’t have the time to look into suspicious requests for a prescription, so not all drug shoppers are successfully identified or stopped.
Yet benefits from such efforts are being achieved. San Juan Regional Medical Center in Farmington, New Mexico saw a decrease in emergency room visits of 5 percent a year after instituting a program to discourage drug shopping. Since many of those coming to the ED for narcotics tended to be uninsured, the hospital began saving an estimated half a million dollars per year, an amount they noted could cover six full-time nurses in the ED.
State Laws Are Producing Results
In addition to the use of tracking systems, other techniques outside of the hospital are being considered to combat this ever-growing problem. In 2012, Kentucky’s prescription drug abuse legislation, House Bill 1, took effect – it was the first state law focused on cracking down on drug shoppers and diverters. The legislation included multiple strategies to prevent the abuse and diversion of prescription drugs.
Since then, the state has experienced a significant drop in the number of prescriptions for the most commonly abused medications. Further, doctor shopping has decreased by 50 percent, and more residents of the state are pursuing treatment for addiction. These findings, along with others, come from researchers at the University of Kentucky College of Pharmacy’s Institute for Pharmaceutical Outcomes and Policy, who examined the impact of the legislation in a recent yearlong study.
Through such research, the healthcare industry now has tangible proof that commitment to solving the issue of drug shopping can in fact lead to real, concrete results.