Opioid Abuse a Top Public Health Challenge | News | Loyola Medicine
Monday, February 23, 2015

Opioid pain reliever abuse called a top 5 public health challenge

Loyola Emergency Department pharmacist offers insight into the growing addiction cycle

MAYWOOD, Ill. (February 17, 2015) – The Centers for Disease Control calls prescription painkiller abuse "one of the worst drug overdose epidemics in history."

New studies on prescription painkillers show that from 1999 to 2011, the consumption of hydrocodone more than doubled and oxycodone use increased by 500 percent. During that time, opioid pain reliever (OPR) overdose nearly quadrupled. 

"The rise in opioid consumption has resulted in a doubling in visits to the emergency department for nonmedical OPR use but I also see patients who make errors with medications they are legitimately supposed to be taking," says Megan Rech, emergency medicine pharmacist, Loyola University Health System. Dr. Rech is a registered and licensed pharmacist with advanced residency training in critical care and is a dedicated pharmacist for Loyola’s emergency department. 

Addicts will frequent emergency rooms complaining of phantom conditions to try to get painkillers. "At Loyola, we limit painkiller prescriptions to last between 7 and 10 days with no refills, to avoid abuse and to make sure people who are genuinely ill see their doctor for follow-up care," says Dr. Rech. "At Loyola, we utilize an Illinois database that tracks scheduled prescriptions to help identify OPR addicts."

Addiction is defined as continued use of a drug despite negative consequences.  

"Red flags that a patient may be an addict include complaining of general pain or excess pain compared to the exam, refusing to see a specialist or to contact his/her primary care physician, asking for brand name painkillers, or displaying an overfamiliarity with opioids," says Dr. Rech. 

Loyola emergency medicine physicians often will opt for non-opioid forms of pain relief. As an Emergency Department pharmacist, Dr. Rech screens appropriate patients for presence of any medication or substances and counsels staff and patients on prescriptions.   

Dr. Rech is also careful to stress the importance of patient education. "Many patients are also unaware that they can build up a tolerance to medication. If they stop taking prescribed painkillers for a while, the tolerance decreases," says Dr. Rech. "A patient can then restart the medication at the previous dose, which is now too high, increasing the risk of an overdose."

"When physicians prescribe medication, they need to be very clear with the patient on what it is, when it should be taken, when it should be stopped and disposed of and if it is habit-forming," says Dr. Rech. "Some patients make honest mistakes with self-dosage that unfortunately result in overdose."

Loyola’s Emergency Department receives some of the region’s most critically ill and injured patients and the severity level of emergency admissions is among the highest in the country. Loyola emergency medicine physicians are board-certified and treat more than 50,000 seriously ill and injured patients every year, including major trauma, stroke, high-risk obstetrics, unstable cardiac conditions, poisonings and severe illnesses. The 31-bed emergency facility is one of the most advanced in the Midwest and contains specialty care sections for trauma, cardiac care and pediatrics. Specialty services at Loyola include a level 1 trauma center, aeromedical transport, chest pain emergency evaluation center, pediatric emergency care and stroke center.

As an academic medical center, Loyola offers professional education to emergency medical technicians and also conducts clinical research trials. As part of Loyola’s leadership in preventing and diagnosing infectious disease, Loyola offers a free HIV test to all Emergency Department patients. 

About Loyola Medicine and Trinity Health

Loyola Medicine, a member of Trinity Health, is a quaternary care system based in the western suburbs of Chicago that includes Loyola University Medical Center (LUMC), Gottlieb Memorial Hospital, MacNeal Hospital and convenient locations offering primary and specialty care services from 1,877 physicians throughout Cook, Will and DuPage counties. LUMC is a 547-licensed-bed hospital in Maywood that includes the William G. and Mary A. Ryan Center for Heart & Vascular Medicine, the Cardinal Bernardin Cancer Center, a Level 1 trauma center, Illinois's largest burn center, a certified comprehensive stroke center and a children’s hospital. Having delivered compassionate care for over 50 years, Loyola also trains the next generation of caregivers through its teaching affiliation with Loyola University Chicago’s Stritch School of Medicine and Marcella Niehoff School of Nursing. Gottlieb is a 247-licensed-bed community hospital in Melrose Park with 150 physician offices, an adult day care program, the Gottlieb Center for Fitness, the Loyola Center for Metabolic Surgery and Bariatric Care and the Loyola Cancer Care & Research at the Marjorie G. Weinberg Cancer Center at Melrose Park. MacNeal Hospital is a 374-bed teaching hospital in Berwyn with advanced inpatient and outpatient medical, surgical and psychiatric services, advanced diagnostics and treatments. MacNeal has a 12-bed acute rehabilitation unit, a 25-bed inpatient skilled nursing facility, and a 68-bed behavioral health program and community clinics. MacNeal has provided quality, patient-centered care to the near west suburbs since 1919.

Trinity Health is one of the largest multi-institutional Catholic healthcare systems in the nation, serving diverse communities that include more than 30 million people across 22 states. Trinity Health includes 94 hospitals, as well as 109 continuing care locations that include PACE programs, senior living facilities and home care and hospice services. Its continuing care programs provide nearly 2.5 million visits annually. Based in Livonia, Mich., and with annual operating revenues of $18.3 billion and assets of $26.2 billion, the organization returns $1.1 billion to its communities annually in the form of charity care and other community benefit programs. Trinity employs about 133,000 colleagues, including 7,800 employed physicians and clinicians. Committed to those who are poor and underserved in its communities, Trinity is known for its focus on the country's aging population. As a single, unified ministry, the organization is the innovator of Senior Emergency Departments, the largest not-for-profit provider of home health care services—ranked by number of visits—in the nation, as well as the nation’s leading provider of PACE (Program of All Inclusive Care for the Elderly) based on the number of available programs.