Treating Patients with Opioid Related Conditions

By: Debra Susie-Lattner, MD, MBA, Vice President of Medical Management

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On any given day, patients come to Condell’s Emergency department for treatment for opioid related conditions. They can present in a variety of ways, such as many who are seen for what is termed “drug seeking behavior.” Physicians may suspect drug seeking behavior particularly in patients who are complaining of a 10 rating on their pain (on a scale of 1-10, with 10 being the most severe) with little identifiable physiologic basis, and these patients may also be asking for pain medications by name, and/or they may be requesting a refill on an opioid, and/or they may be reporting that their opioids were lost or stolen, and/or they may be asking for particular intravenous pain medications. The other end of the spectrum are those patients who present in the most tragic of ways after suffering fatal overdoses from opiates. When this happens to a national figure, such as Prince, there is public mourning for a while and then life goes on. When it happens to your child, sister, or other loved one, it is a tragedy you never fully recover from.

There is an increased awareness and resources are available to help patients with opioid related conditions at Condell. Rich Dilger, LCSW (licensed clinical social worker), is based in the emergency department and partners with the physicians and nurses to assist patients identified with opioid related conditions. He offers nonjudgmental help to these challenging patients, whether or not they are ready to acknowledge their opioid addictions. He begins with a conversation about a patient’s background, and then tries to develop an understanding of that patient’s awareness of his/her opioid addiction, and his/her receptiveness to changing behavior. Once he establishes those aspects, he has a variety of options he can pursue with patients, depending on the severity of their presentations. These options can range from providing educational materials, including treatment options and contact numbers, to facilitating placement in inpatient drug treatment programs if patients are medically stable. Rich reports that it takes a lot of patience to work with this challenging population. When patients return to the emergency department with recurrent opioid related conditions, he sees it not as a failure but as another opportunity to help them.

Addressing the Opioid epidemic successfully is going to take the collaboration of attentive caring families, public health initiatives, such as Lake County’s Opioid Initiative, engaged police departments, such as those involved in “A Way Out” program, and compassionate and knowledgeable caregivers. Any fatal overdoses avoided with successful interventions are one less lifelong tragedy to be endured by loved ones.