A look at the opioid epidemic and what ED providers can do to combat this formidable foe.
Core EM - Emergency Medicine Podcast Episode 161.0 – Opioid Epidemic
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Apr 22, 2019 In this discussion, Ian Whitman, an emergency medicine expert and Chief at NYU Langone Health Brooklyn, dives deep into the opioid epidemic. He highlights compelling strategies for ED providers to combat this crisis, including non-opioid pain management options like NSAIDs and ketamine. Ian argues for better naloxone distribution, not just for overdoses, but as a preventative tool. He also discusses the importance of linking patients to ongoing care and the potential of buprenorphine treatment within EDs. It’s an eye-opening conversation about practical solutions in emergency medicine.
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EDs Are Central To The Opioid Crisis
- Emergency departments are the main touchpoint for patients with opioid use disorder and thus a critical place to act.
- Opioid deaths now exceed motor vehicle deaths and are the leading cause of death for Americans under 50.
Prioritize Non‑Opioid Pain Care
- Use non-opioid first strategies like NSAIDs, subdissociative ketamine, and ultrasound nerve blocks for acute pain.
- Reduce EMR prescription defaults to short supplies to cut opioid pills dispensed without harming quality.
Use PDMPs And Short Prescriptions
- Mandate prescription monitoring checks (e.g., I-STOP) for multi-day opioid prescriptions to limit diversion.
- Default prescription durations to a few days rather than 30-pill defaults to immediately reduce pills leaving the ED.