Alliance for Substance Abuse Progress

Ask the Expert: What’s it like to work in the ED?

December 27, 2017 By Dr. Kevin Terrell

I began working in the CRH Emergency Department in January 2012. During my first year or two, I rarely saw patients with opioid overdoses. However, beginning a couple of years ago, we began seeing more and more prescription pill overdoses. The even more frightening thing is that we now see numerous overdoses from heroin and illicitly made fentanyl in the ED. Fortunately, our community law enforcement officers now carry Narcan–the opioid reversal agent. Patients are transported to the ED after law enforcement or EMS administers Narcan. Occasionally, “friends” will drop patients off at the door of the ED, and the ED crew will carry the patient into a room to receive Narcan.

The most difficult part of this is when family members arrive after the patient receives Narcan. The families are a mix of angry, embarrassed and thankful. It really is heartbreaking to see them in tears because their loved one has overdosed–overdosed again in many cases.

Another challenge of the job in the ED is the number of patients who come in solely to get help with their opioid addiction. Many times, patients will come with family members. The sad part of this is that there currently is no way for someone to get immediate treatment within our county. Our county isn’t alone in this respect. Few counties in Indiana have developed the resources for patients to get immediate help when they go to the ED. This leads to unhappy patients and often furious family members.

We haven’t yet assembled all of the resources we will need, but there is very good news coming in the near future. ASAP and Columbus Regional Health are working with Centerstone to assemble a real-time response for patients who receive Narcan and for patients who show up simply to get help. The details of this exciting initiative are being worked out, but we expect that these two particular programs will be up and running in the next month or two. I look forward to the near future, when people will be able to get the help they really need right away.

Category: Ask the Expert, General