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Guidelines help MGH control opioid prescriptions

NEW GUIDELINES: This chart shows the usage of marijuana, cocaine, pills/prescriptions, methamphetamines, heroin and bath salts in Grant County. The arrow pointing to the green line marks the moment Marion General Hospital implemented new prescription guidelines. Though the hospital has reigned in its prescribing practices, MGH is now battling a rise in heroin cases.

BY Dezaray Barr - ctreport@indy.rr.com

In 2014, the Grant County Opioid and Substance Abuse Task Force realized that Marion General Hospital was partially responsible for the massive amount of opioid pills being prescribed to Grant County residents.

Because 80 percent of heroin users begin their addiction with prescription pills, MGH was one of the biggest contributors to the opioid crisis.

“We, as health care people, have noticed increasing prescriptions and increases in the number of pills being given,” said Pamela Leslie, the Parish Nurse Program coordinator at MGH.

The Joint Effort Against Narcotics Team Drug Task Force approached MGH, making them aware they were the biggest supplier of opioid pills in Grant County.

“(J.E.A.N. told us), ‘You guys don’t help the situation,’” said Kelley Hochstetler, the Community Education coordinator at MGH.

According to Ann Vermilion, administrative director of MGH’s Medical Staff Services and Community Outreach, MGH is a rural hospital taking ownership of the opioid and heroin epidemic and vowing to make it better.

MGH pulled together a team and put new prescribing guidelines in place for both the emergency department and in all MGH physician offices.

These new guidelines include prescribing a smaller amount of pills in a prescription when a patient is complaining of pain, such as prescribing a three-day supply of medication instead of a 45-day supply.

“This puts doctors in a hard spot,” Hochstetler said, “because these patients just keep coming in with complaints of pain … but we do want patients to be comfortable and healthy.”

Another guideline implemented is all MGH physicians now have the capabilities and are expected to look up each patient by name in an online statewide system to see if that patient is already receiving a prescription for pain.

The same day the new guidelines were implemented opioid pill cases dropped significantly.

However, the number of heroin cases increased at the same time.

“The opioid crisis in Grant County is a very challenging place (for MGH) to be,” Leslie said.

MGH officials knew that heroin use would increase as a reaction to the new guidelines that restricted the usage of and accessibility to opioid pills, according to Hochstetler.

“All of the best practices say to get the pills under control first, because that keeps from creating new addicts,” Hochstetler said. “But the problem is that those coming off of the pills … now they can’t get them anymore, so they’re seeking heroin instead.”

Now that MGH has addressed the issue of pills, they’re hoping to make some progress on the heroin epidemic in the future.

Hochstetler said that although this opioid crisis is happening in Grant County, this area is not alone. It is happening all over the country.