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Healthcare providers get tougher on opioids
Opioid series part 2
Liberty County first responders carry Narcan in case they encounter people overdosed on opioids. - photo by Asha Gilbert

Editor’s note: This is the second in a series about the national opioid epidemic, and how it affects our community.

Opioids is a crisis facing every community in America today, both urban and rural. Coastal Georgia hospitals and physicians in Liberty County have witnessed an uptick in patients who are addicted to opioids during the past decade, and have had to take more restrictive measures to combat the epidemic. The challenge is to keep up with the changing landscape among drug users, who continuously find alternative ways of acquiring these substances.

In the neighboring county of Effingham, the Effingham Health System agreed to pay the United States a $4.1 million settlement in May due to the failure of following procedures to guard against theft and loss of controlled substances according to The settlement was the largest hospital drug diversion civil penalty settlement in U.S. history.

“Hospitals have to be proactive,” said Chief Nursing Officer Donna Cochran of Liberty Regional Medical Center. “We no longer do refills [on controlled substances], the maximum dispensed is in the emergency room and 30 day supplies are no more.”

According to Agency for Healthcare Research and Quality Georgia had a 99.8 percent increase in the rate of opioid-related hospital stays between 2009 and 2014, the highest in the country.

The Georgia Department of Health reports from 2010 to 2016 the total number of opioid-involved deaths increased by 117 percent. In 2016 there were over 16,000 overdose emergency department visits and hospitalizations reported by the DPH.

Shawn Parker, the Director of Emergency Medical Services, says that the opioid crises isn’t limited to criminals and can affect anyone.

“We have seen an increase in overdoses in the community,” said Parker. “We administer Narcan in this community multiple times a month.”

Naloxone, commonly known as Narcan, is the medication used to block the effects of opioids especially in overdoses.

In the past only EMS carried Narcan, but with the passing of the Georgia’s 911 Medical Amnesty Law, access expanded to authorized first responders including law enforcement officers and firefighters.

Narcan now can also be prescribed by licensed physicians and filled by licensed pharmacists as long as they are complying with state regulations.

“The problem in the field is that the drug users are unaware of the potency in the drugs,” Parker said.

Now emerging on the drug scene is carfentanil, a synthetic clone of fentanyl.  According to carfentanil is 10,000 times more potent than morphine and has been used to sedate animals as big as elephants.

Parker says that due to the state hammering down on opioid prescriptions, people are turning more to illicit drug use.

“What we carry may not be strong enough to override the effects of these stronger drugs,” Parker said. “There have been times where paraphernalia is still on their person when first responders arrive [to an overdose],” said Parker. “The drugs can be so potent where the paraphernalia is still hanging in their arm.”

 In 2016, Georgia had a reported 1,394 drug overdose deaths according to the Center of Disease Control and Prevention. According to data retrieved from the Liberty Regional Medical Center, between 2014 and 2016 there were a reported 15 drug overdose deaths in Liberty County.

Cochran states that there is now a stigma in the hospital in treating patients with pain medication.

“They’ll [patients] come in with a list of drugs they’re allergic to against the new front line of drugs used to treat pain,” Cochran said.

This new front line of drugs includes: NSAIDS (nonsteroidal anti-inflammatory drugs) like ibuprofen/Motrin, and toradol.

“You have to work harder to filter out who needs what,” said Cochran.

The medical center has seen an increase in patients who have a history of opioid addiction, harmful use, dependence, withdrawal, and psychotic use as a result according to records provided by the medical center.  In 2016, the count of patients was 50. In 2017, the number increased to 59 and in 2018 the number of patients is up to 32 as of July.

At the Liberty Regional Medical Center they have started using drug screens to help filter what types of pain medication are dispensed to the individual. Within the last three years they have also started using a databank system that can retrieve what prescriptions the individual has gotten in the past.

“Nobody is exempt from it,” Cochran said.

Dr. Glenn Carter says he began emphasizing on narcotic treatment 15 years ago.

“We started doing narcotic treatment due to the need… it’s just an epidemic,” said Carter.

One of Carter’s patients, Stevie, who preferred his last name not be used, knows how easily you can fall into opiate dependency.

“It was accidental,” Stevie said. “After my wife had her first child she had pain medication and one day I had a backache and took one of her pills.”

His choices of opioids were Percocets, Darvocets and Lorcets.

“I immediately fell in love,” Stevie said.

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