Dear Editor:

Considerable attention has been given in the news media of late to one of the most significant and damaging health care issues presently facing the state of Kentucky – the abuse of prescription pain medications. Nowhere is this problem more evident than in hospital emergency departments. As the predominate health care provider for our county, the medical staff and Board of Directors of Twin Lakes Regional Medical Center took action in 2008 to address this problem in an attempt to protect our communities from this abuse.

We would like to take this opportunity to reiterate our policy with regard to the prescribing of pain medications within our Emergency Department. For any patient who comes to the TLRMC Emergency Department and, after an appropriate medical screening, it has been determined that an emergency medical condition does not exist, the following actions will be taken:

• Prescriptions for narcotic and sedative medications that have been lost or expired will not be refilled. Patients who have chronic pain will receive non-narcotic pain medications as interim treatment. It is every patient’s personal responsibility to maintain active prescriptions with their primary care of specialty physician.

• Patients who have frequent or multiple visits to the Emergency Department seeking relief from painful conditions such as migraine headaches, back pain, dental pain, pelvic or ovarian pain, kidney stones and fibromyalgia will be prescribed non-narcotic pain medication.

• Emergency Department physicians will work with patients to assist in the arrangement of appropriate follow-up care, but continuation of narcotic analgesics through the Emergency Department will not be done.

• In the event of an acute medical problem for which the Emergency Department physician feels it is appropriate that a patient be given a narcotic or sedating medication, our hospital will require that a driver for that patient be physically present in the patient’s room before the medication will be administered.

• If it is the professional judgment of Emergency Department physician that a narcotic prescription is necessary for the care of an acute medical problem, the prescription will be for a limited quantity, sufficient enough for the patient to follow up with his or her primary care physician or specialist. Any patient returning to the Emergency Department for a refill of said medication will be prescribed a non-narcotic analgesic.

With the continued support, cooperation and assistance of the people we serve, we can work to address a growing problem within our society before it becomes a widespread issue within our own community.

Sincerely,

Stephen L. Meredith

Chief Executive Officer

Twin Lakes Regional Medical Center