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To Curb Opioid Use, Carolinas HealthCare System Using Alternative Treatments

Alex Olgin

President Donald Trump announced his intent to declare the opioid crisis a national emergency. Once that is official it would free up government officials to dedicate more people and resources for treatment. Carolinas HealthCare System is trying to curb the amount of opioid medicines patients are introduced to while in the hospital with alternative treatments.

Nurse Chelsea Blalock picks up bottles of scented oils on what she calls a comfort cart.

“We have clary sage, vanilla, bergamot, which is like a citrus, like a mandarin lemon, lavender, peppermint,” she said.

These scented oils are now part of an array of non-drug post-op treatments on the trauma floor of the Carolinas Medical Centerhospital in Charlotte. The theory is reducing patient anxiety can help reduce their perception of pain.

Blalock said when she goes into a patient's room and offers aromatherapy she tells them, “This might not make your pain a zero, but that may not be our goal right now, because that may not be something we can achieve.”

Blalock and other nurses use also ice and Reiki, the Japanese relaxation technique, to help reduce anxiety with patients. It’s all part of a larger effort to reduce the amount of opioids patients get while in the hospital.

93-year-old Wesley Collins was in the hospital because he fell in his kitchen. He injured his head and broke a bone in his leg. He’s recovering from a surgery where doctors put pins in his leg. His wife Gail Collins is at his bedside.

She said, “They gave him Tylenol this morning and I think he’s more comfortable. Are you feeling a little more comfortable honey?”

“Yes,” replied Wesley.

“He’s not totally out of the woods yet, but he will be,” Gail said.

Wesley isn’t on any opioid medications. He’s icing his leg and has lavender aromatherapy in his room in addition to Tylenol. His wife Gail is pleased with that treatment regimen.

“Both of us had experience with people in our family who have had addictions so we are both really strong on not taking anything that you don’t need,” Gail said.

Wesley’s surgeon, Doctor Joseph Hsu, is on board with that. He’s part of the effort in the trauma department to prescribe patients fewer opioids while they are still in the hospital. Hsu said it's much safer, especially for older patients like Wesley.

“People with his types of chronic medical issues and risk factors may sometimes even get overdosed in hospitals to the extent that they have to have rescue medications,” Hsu said.

The hospital wouldn’t provide details on how many patients they have had to rescue in their facilities. Dr. Rachel Seymour is one of the researchers leading the project. She said many people are first introduced to opioids when they are admitted to the hospital.

“This is where it starts for a lot of people,” said Seymour. “So if we can use the lowest doses of opioids possible, teach people to appropriately manage expectations around pain and use some of these alternative strategies. They are going to be using lower doses of opioids in the hospital and that should make their recovery safer.”  

Those lower doses are used in combination with alternative treatments for patients in the trauma department. The process starts when they are admitted. It’s been underway at Carolinas Medical Center for about six weeks.

Doctors and nurses acknowledge not all patients are keen on trying these alternative treatments, which are optional, after a major surgery. Nurse Karon Wold said it can take some convincing.

“Initially if you walk into the room of somebody who’s, the terminology we use, is broke up like dishes and say I have some lavender would you like to try that. Sometimes it helps to decrease your pain,” said Wold. “They usually laugh at you and say no I want pain medication.”

Carolinas HealthCare System and 15 other health care networks are part of a$347 million two-year effort by the Centers for Medicare and Medicaid Services to make hospital stays safer for patients. One of the goals is a 20 percent reduction in patient harm by 2019. Each health care system is developing different ways to do that and tracking results.

Carolina HealthCare System said many of these therapies don’t cost patients extra and aren’t increasing the length of hospital stays. Wold is happy about the change.  

“I’ve been in trauma for 22 years,” she said. “We have seen a lot of stuff and a lot of addiction go out the door. And the fact we are changing the culture makes me feel so much better about sending people home on drugs.”

Carolinas HealthCare System is planning to expand the program to 12 hospitals within the next year.