Congressman Donald Norcross

Representing the 1st District of New Jersey
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How doctors at this N.J. hospital are fighting the opioid crisis

May 13, 2017
In The News

The Star-Ledger. By: Amanda Hoover

WASHINGTON TWP -- Kennedy University Hospital has spent the past two years taking steps to curb opioid distribution and provide recovery options to those struggling with addiction, ultimately seeing a drop in abusers seeking medication from the hospital. 

But without legislation to increase hospital access to cross-state data and patient access to health care and treatment centers, those behind the initiatives worry that the next steps could be out of their hands. 

That's why they invited Rep. Donald Norcross (D-Camden) to the hospital system's Washington Township campus Friday.

"This is a grassroots campaign," said Dr. James Baird, attending physician in emergency medicine. "Just not enough people care, and if they don't care, they don't know how bad it is."

Touring the emergency room, the congressman met with doctors, nurses, hospital staff, and recovery volunteers in an effort to bridge the medical and legislative fields. 

"The motivation happens every day" in the fight against addiction, Norcross said. "This isn't just going to go away." 

In 2011, the nursing staff started to examine the list of patients who had visited the emergency room for pain more than three times in six months. 

Among that group, they found just 21 people had come through the doors of the emergency room 903 times for pain, averaging around eight visits per month. That indicated that the hospital was dealing with a growing number of "superusers," or people seeking to abuse the system for pain medication. 

Those numbers, coupled with the state and nationwide rates that have risen over the past decade as the opioid epidemic grows, convinced the hospital that they had to act. 

"There's a whole generation of doctors who don't know how to treat pain without prescriptions," Dr. Baird told Norcross in a presentation.  

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The hospital's staff took a multifaceted approach to fight the issue in 2015. They invested time and efforts in re-educating physicians on addiction, and have since added a pain management rotation for medical students. Doctors and nurses also spend time educating patients on proper narcotics use, and provide alternatives to pain management before resulting to prescribing narcotics. 

And they're also keeping a close watch on those who come to the emergency room frequently complaining of pain; when someone who staff expect is abusing the system signs in, nurses receive text messages letting them know that patient could be seeking pain medication without a condition. 

The efforts have resulted in a 25 percent overall decrease in opioid prescriptions from 2015 to 2016.

But the hospital still sees too many overdoses, Dr. Baird said. Over the same two-year period, the three Kennedy University Hospitals saw more than 3,300 overdoses, with the Washington Township branch dealing with 423 in a single year. 

The staff knows they can't fight the problem alone. They've partnered with Sgt. Danielle LoRusso of the Gloucester County Prosecutor's office, who runs educational community programs at schools to reach both students and their families, and Michelle Perez, a volunteer recovery coach with City of Angels NJ, a free addiction treatment program. 

Perez and other recovery coaches now step in when patients take up offers for help, filling a role the hospital can't, as doctors and nurses there focus on distributing Narcan when a patient has overdosed. 

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Between the beginning of April and Friday, Perez said her organization has met with 45 people seeking recovery. 

All of this, Dr. Baird said, hasn't brought any additional financial costs to the hospital, which worked within its existing resources to make the changes and relies on volunteer recovery services like the City of Angels. 

But there are others across the region struggling with addiction who go uncounted -- people abusing alcohol or heroin, who are less likely to come to the hospital seeking pills, and those who cross state lines seeking different prescriptions that are harder to track. 

And that's where the hospital hopes Norcross and other local legislators and leaders can step in. While data sharing between New Jersey and New York and Delaware has been established, doctors across the river in Pennsylvania can't currently share prescription history information with those in New Jersey, but they know that a significant portion of those seeking Narcan in the hospitals are coming from the Philadelphia area.

Dr. Baird also implored Norcross to fight for the establishment of treatment facilities in more neighborhoods, and require them to accept Medicaid and Medicare.  

But there are larger, societal issues at play that can create obstacles to treatment. 

"The issue of shame is still a major component of how people decide to seek treatment," Norcross said during the meeting.  

And there's also the issue of health care access that both Norcross and Dr. Baird worry could put a damper on treatment efforts. Following the House of Representative's vote to repeal the Affordable Care Act last week, many worry that a drop in insurance rates could lead to a drop in people seeking treatment.

Either way, the hospital plans to continue on its path, and hopes that others might follow. 

"It's going to up-end people seeking care," Dr. Baird said of the change. "The programs are still going to be here. Whether we can help as many people is the question."