Treatment Archives | Emerald Coast Medication Association

“With the first cut of the scalpel, excruciating pain exploded in my foot, and I was shocked speechless. I froze, paralyzed, terrified that any movement would jostle that knife digging into my flesh.” Angelika Byczkowski, a patient suffering from Ehlers-Danlos Syndrome (EDS) has felt multiple surgeries through anesthetics.

The unforgettable recollection above was from a procedure that was done on her foot to remove a plantar wart. She also felt pain when she received stitches, which had anesthetics applied. Her doctor told her it was impossible that she was feeling pain, so she stuck to it and all the while, feeling extreme amounts of pain run through her body, she sat there quietly because she did not want to question authority. She thought she was going crazy. However, once she was 54 years old, she was finally diagnosed with EDS. EDS in many patients has brought them pain even after being numbed through local anesthetics. However, now that the medical world has gotten more advanced, we can help people with EDS with what is called by many a last resort: Opioids.

There is a four-step procedure to be taken before providers prescribe opioids:

Step 1: Initial Assessment

An Evaluation of the patient’s pain, which should include; location of pain, duration of pain, characteristic of pain, what relieves the pain, and what time of day the pain occurs. There should also be a check on how the patient’s past treatments and medication have worked out. A look at the patients personal and family history of alcohol or substance abuse should be taken into precaution.

Step 2: Informed Consent and Treatment Agreement

Before prescribing opioids for the treatment of chronic pain, a practitioner should obtain an informed consent agreement and a treatment agreement.

Step 3: Initiating and Monitoring Treatment

Once the decision has been made to initiate the opioid treatment, it should start as a therapeutic trial for a defined period (not to exceed 30 days). The patient should know that the trail will be carefully monitored to assess the benefits and harm that may occur and to evaluate the level of and change in pain.

Step 4: Red Flags and Aberrant/Diversionary Behavior

There is no exhaustive list of behaviors that might be considered red flags. However, it is a must for practitioners to recognize such behaviors and to document them in the medical record as well as what actions have been taking, including discontinuance of opioid treatment or discharging the patient.

With all of that in mind, opioids are there to help the patient try to function normally in day to day life. It should not be the medical professional’s fault for the patient’s actions. The war on opioids is not helping anyone in this situation because it can cause more problems for the patient by not giving them the drug sooner. Medical professionals are doing everything they can to help their patients; it’s their job, and most often their passion. The war on opioids has been causing more problems than solutions in the medical field and has even led to medical professionals to be questioned.

At Emerald Coast Medical Association, we always have your back. Our Board of Governors routinely take their time to advocate for patients and physicians at the local, state, and federal level. Why wait when you can join today?

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Over the last decade, the number of individuals struggling with mental health issues has increased, while the number of inpatient beds for mental health patients has continually declined. The journal Psychiatric Services estimated in 2017 that more than 8 million Americans were suffering from serious psychological problems. Unfortunately, this coincides with an ongoing trend of deinstitutionalization that began over 50 years ago when state hospitals decided that many of their mentally ill inpatients would do just as well in the community.

Last year Dominic Sisti, director of University of Pennsylvania’s Scattergood Program for Applied Ethics of Behavioral Health Care, told NPR that in the late 50s and early 60s “State hospitals began to realize that individuals who were there probably could do well in the community. It was well-intended, but what I believe happened over the past 50 years is that there’s been such an evaporation of psychiatric therapeutic spaces that now we lack a sufficient number of psychiatric beds.”

At the time, people felt that community based care options would serve patients more effectively and economically. Unfortunately, over the years, support for these programs has been inconsistent, and a group of people who truly do need inpatient care are unable to get it due to economic barriers or just straightforward shortage of beds.

Thankfully, some hospitals are addressing the lack of facilities with the expansion of existing mental health facilities or even the creation of new ones. Tina Reed, Executive Healthcare & Hospitals Editor for FierceHealthcare, reports that the Children’s Hospital of Richmond at VCU recently redesigned its behavioral health center, adding 8 more beds. San Francisco opened a new 54-bed inpatient facility, Mercy Medical Center revealed plans for a psychiatric hospital in Iowa with room for 100 patients, while more psychiatric hospital projects have already been built or are underway in the Northeast United States.

Meanwhile, in Falls Church Virginia, Inova Health Systems will debut their new behavioral health inpatient unit, which offers private rooms, space for group therapy, natural light, and high tech safety features which includes doors that cannot be barricaded. With a separate floor for teenagers, this facility looks to provide specialized mental healthcare with a staff dedicated to preventing suicides and overdoses, treating anxiety, depression, and substance abuse before it’s too late.

The shortage in beds has spurred this growth, but Inova is committed to providing not only top flight inpatient care for mental health, but also follow-up programs and integrated help from social workers and counselors to provide coordinated outpatient treatment once the patient is back at home.

Michelle Mullany, Inova’s assistant vice president of behavioral health says that investing in units such as theirs are an important step toward changing the current landscape of mental healthcare in the United States. “We don’t necessarily give enough time to see how the trajectory of the improvement is on those medications, we discharge folks,” she says, in regard to the general state of mental health care our country, “Having an increase in beds will help us prevent readmission and really get that treatment right from the beginning.”

Emerald Coast Medical Association recognizes the importance of mental health providers to the healthcare landscape. We are proud to have many fine psychiatrists as members, and we value their contribution to the care and well-being of our local patients. We encourage you to search our listings for our mental health care specialists or any sort of practitioner you or your patients may need. When we work together, we effect change, on a large scale as well as among individuals.

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Category: Treatment

The “War on Opioids” Needs to End

Remedying the Shortage in Mental Healthcare