Amidst a national epidemic of prescription opioid abuse, 80 public and private urgent care clinics across Los Angeles County will now follow guidelines designed to combat overuse of the powerful pain medications, the county public health department announced Friday.
The move will help address a surge in patients asking for opioids at urgent care clinics, says Dr. Gary Tsai, medical director for the Substance Abuse Prevention and Control division of the L.A. County Department of Public Health. The increase in drug seekers came after all 76 emergency departments in L.A. County adopted the same prescription guidelines last year, he says.
"People are very adaptable and good at getting what they need, Tsai says. "If they are unable to get what they need in terms of opioids in one setting, sometimes they'll go to other settings."
L.A. County Public Health and Safe Med LA, a countywide prescription drug abuse coalition, are coordinating the effort with the urgent care clinics. Ten major physicians groups and health systems are participating, including the L.A. County Department of Health Services, Kaiser Permanente, UCLA and Health Care Partners.
The 80 clinics represent less than one-third of the estimated 262 in the county, says Tsai. He says it's a challenge to corral every clinic, but he is confident that "once other urgent cares hear about this initiative, that they'll want to be involved."
Tsai says organizers also plan to work on getting the guidelines adopted at dentists' offices, where an estimated 12 percent of opioids are prescribed.
"Any prescriber plays a role in the opioid epidemic, whether it's medical, dental or other health fields," he says.
The guidelines, established by the American Academy of Emergency Medicine, advise clinicians to try to address pain with non-opioid treatments first. If there is a clear need for opioid medication, then they should start by prescribing the lowest effective dose of opioids and for no more than three days, the guidelines say.
Doctors are advised to consider screening patients for opioid misuse or addiction, and to refrain from replacing lost opioid prescriptions or refilling opioid prescriptions for chronic pain.
The guidelines are not intended for people with cancer or a terminal illness.