New York City hospitals to limit outpatient opioids to 3-day supply

To help prevent opioid abuse, New York City hospitals will be limiting opioid prescriptions dispensed from its emergency departments to a three-day supply, will not be prescribing long-acting opioids, and will not be refilling lost, stolen, or destroyed prescriptions, according to new voluntary emergency room guidelines that were made available on Jan. 10.

The guidelines were issued in a report from Mayor Michael R. Bloomberg’s office, “Mayor’s Task Force on Prescription Painkiller Abuse.” The task force was created in late 2011 to develop and implement strategies in response to the growing epidemic of opioid painkiller misuse and diversion in New York City, the report stated.

Between 2004 and 2010, the number of painkiller-related emergency room visits climbed by 143% in the city, from 55 visits per 100,000 people to 143 visits per 100,000. In 2010, there were 173 unintentional overdose fatalities in New York City related to painkillers, a 30% increase from 2005. In 2008-2009, approximately 4% of the New York residents aged 12 and older reported misuse of prescription opioids, a 40% increase from 2002 to 2003.

“These new guidelines effectively balance our mission to relieve patients’ pain against concerns about drug abuse, dependency, and the illicit diversion of opioid medications,” said Dr. Ross Wilson, senior vice president and chief medical officer for the New York City Health and Hospitals Corporation, in a press statement.

The guidelines will be adopted by 11 emergency departments of the New York City Health and Hospitals Corporation, which operates all the public hospitals in the city. The Health Department is encouraging private hospitals to also follow the guidelines.

The New York City Health and Hospitals Corporation has also reduced the “default” for prescribing opioids electronically within its electronic health record system to ensure that patients will received the reduced recommended supply, the report noted.