Page 17 - Christiana Care Focus October 2018

“Our repeated education of Delaware ACEP guidelines, along with initiatives like Middletown’s Opioid Alternative Environment and the Suboxone pilot, has helped us treat pain in an appropriate manner without prescribing needlessly.”
John T. Powell, M.D., MHCDS, FACEP
ED cuts opioid prescriptions in half
Christiana Care’s Emergency Department, too, is engaged in finding alternatives to treat acute pain.
Christiana Care’s three emergency care facilities are successfully tackling the addiction crisis from both ends by helping
those with a substance-use disorder access treatment I and by prescribing opioids more appropriately.
ts success in cutting by nearly half the rate of opioid prescriptions among discharged patients, to eight percent in May 2018, is thanks to a combination of several efforts, including the implementation of new
opioid prescription guidelines developed by the Delaware chapter of the American College of Emergency Physicians, or ACEP.
Removing the fuel for addiction
Terry Horton, M.D., chief of Christiana Care’s Division of
Addiction Medicine, likens the battle against opioid over- Sprescription and addiction to a raging forest fire.
uch a fire, he said, is most dangerous when it can tap into a ready fuel source, like downed trees and dry undergrowth. If you can remove the fodder, you can limit the risk of a major conflagration.
“Our efforts to prescribe opioids responsibly are reducing the fuel for that fire,” Dr. Horton said.“ 
rry Horton, M.D.
“Our efforts to prescribe opioids
responsibly are reducing the fuel for
that fire.”
Terry Horton, M.D.
“Our repeated education of Delaware ACEP guidelines, along with initiatives like Middletown’s Opioid Alternative Environment and the Suboxone pilot, has helped us treat pain in an appropriate manner without prescribing needlessly,” said John T. Powell, M.D., MHCDS, FACEP, chair of the Department of Emergency Medicine at Christiana Care.
MHCDS, FACEP
| Acute Medicine
By tapping Project Engage’s peer
counselors to meet with patients, the Emergency Departments is identifying those struggling from withdrawal.
When appropriate, the Emergency Department is piloting a program to start these patients on Suboxone, a medication that provides immediate relief from the symptoms of withdrawal, and also connects them with an all-hours treatment center that offers medication-assisted therapy and counseling.
Meanwhile, the Middletown Emergency Department is developing alternatives to opioids in an effort called the Opioid Alternative Environment. That doesn’t mean opioids have no place there, but that other methods — including trigger point injections of anesthetic and, in some cases, IV acetaminophen — will be tried first.
John T. Powell, M.D., Te
FOCUS • OCTOBER 2018 15