Problems with opioid abuse continue to draw attention nationwide, a far-reaching issue that has made its way to Newton and Harvey County.
Last year, Newton Medical Center President and CEO Val Gleason was asked to serve on a joint task force of the Kansas Hospital Association and the Kansas Medical Society to help create a guide to address the opioid epidemic. That collaborative work (and other local efforts) led NMC to recently outline its own plan to tackle the issue of opioid use.
"Newton Medical Center needs to stand up, we need to take a stance. We'd like it to be a unified stance with our hospital administration, with our medical staff and with our board of directors," Gleason said. "We wanted to give guidance on how we're thinking about the problem, but also to inform the public you can get trapped in opioid use. You can get trapped in taking someone else's medicine. You might not think it's dangerous, but it can be, so we just wanted to come out with a rational statement that said what our hospital is doing about this, how we are viewing it."
Over multiple months, current NMC processes and procedures were evaluated while a joint statement on behalf of the hospital was authored — principally by Chief Medical Officer Dr. Charles Craig. Ultimately, NMC's new stance is three-tiered and focuses on reducing opioid usage, improving monitoring and patient education and encouraging alternative pain management methods.
Previously, Gleason noted, hospital regulations were tied — in part — to patient surveys that gauged how "free of pain" they were kept by staff, with unfavorable results penalizing those entities in some cases. That created a fine line for medical staff to walk when it came to prescribing opioids. With that question eliminated, it opens up the path to address the first tier of the plan and reduce opioid usage among patients — though the ability to do so starts with open communication from both parties.
"I think these decisions on prescribing anything, whether it's a Lasix water pill or whether it's an opioid, comes down to the relationship between the prescriber and the person seeking care," Gleason said. "That's where it happens. It happens in that moment in an exam room, in an emergency room; it happens with you being honest with your doctor and your doctor trying to do the best for you based on what you're telling him or her. It all starts with that relationship."
“We have an ethical responsibility to relieve patient pain and suffering. This includes managing pain in a way that will not cause future harm to the patient or our community," Gleason said. "I don't want anybody to take away that we're not going to treat they're pain. Clearly that is not what we're about. We're about the appropriate treatment of pain."
Limiting opioid usage is a one-on-one issue between doctor and patient, but Gleason pointed out that the advent of K-TRACS continues to help with that.
K-TRACS allows medical staff to screen for multiple prescriptions or multiple providers in cases where they fear opioid usage may be getting out of hand.
"Since K-TRACS came into existence and physicians began to consult K-TRACS, the amount of opioid prescribing in Kansas has gone down, so knowledge is power," Gleason said.
For cases in which opioids are prescribed, the second tier of NMC's stance aims to make sure the drugs are used responsibly, whether through the use of pain management contracts, tests, patient education or other means.
"One thing that's really tantamount to what's going on here is creating a dialogue and educating the patient that they have an important role to play in their pain management and making decisions in the get-go on what's prescribed," said NMC Director of Marketing and Communication Shelly Conrady.
Additionally, in line with the final tier of the hospital's plan, other forms of pain management may be suggested in place of opioids, including physical therapy, stress management, exercise, alternative drugs, etc.
Responsibly managing pain is what Gleason said NMC hopes to help its patients do, but at that same time staff have to keep the prime directive of the Hippocratic Oath in mind to "do no harm." That has become trickier amid the growing prevalence of opioid use.
Gleason noted the hospital (and the state of Kansas overall) may not see the same problems with opioids being dealt with elsewhere around the U.S., but that drive to "do no harm" is still in mind. Continuing to collaborate with both NMC and community partners — like law enforcement, first responders, etc. — is key in that, too, as the entity does what it can to address the epidemic.
"We're out to protect and defend more than just our hospital staff and more than just the patients who come to our hospital," Gleason said. "We're out to protect and defend our community from harm."