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As state legislators continue to search for answers to the national opioid epidemic, York County doctors provided insight into the work medical professionals are performing on the issue.

The GOP House Caucus gathered testimony during a four-hour discussion Thursday at the York County School of Technology that concluded an eight-stop tour.

A panel during the discussion that included doctors from Hanover Hospital, WellSpan Health and OSS Health appeared to particularly captivate the Republican representatives.

Dr. Suzette Song, of OSS Health, testified that the practice, which she described as fairly conservative, recently started monitoring prescriptions more closely and found that doctors had written more than 18,000 prescriptions for opioids.

Song pointed to a study that found about 75 percent of drug abusers start their addiction with opioids that they are not prescribed. She said extra pills, or waste, were a major factor that the practice is looking at to combat drug abuse.

By more closely monitoring these prescriptions, Song said OSS Health has reduced its opioid prescriptions by four pills on average.

New policy: Rep. Kristin Phillips-Hill, R-York Township, asked WellSpan's representative, Dr. Eric Kochert, about a new opioid policy the organization was implementing, noting that she had been hearing some complaints from constituents.

Kochert, who works in the emergency room, wasn't able to speak to the policy, but Dr. Chris Echterling, WellSpan's medical director for vulnerable populations, was in the audience and said he spoke with Phillips-Hill after the forum.

Echterling said Phillips-Hill was referring to a controlled substance agreement, which isn't new but was just updated slightly in the spring to make it more clear to patients.

The agreement, which is recommended by the Centers for Disease Control and Prevention, provides proof that the provider and patient engaged in a conversation about the benefits and risks of opioids.

The signed agreement requires patients to agree to, among other things, "not sell or share these drugs with anyone," "not use more than prescribed and ... not request early refills," and that "pill counts and urine drug screening ...may be requested."

Safety: Echterling said the main patient complaints he hears about this agreement are "Why now?" and "I'm not a drug addict, why me?"

With the "Why now?" question, Echterling said he tells patients that the medical field is constantly evolving, and doctors now know opioids are not as effective and are more dangerous than they originally thought.

"That leads to the need for more monitoring," he said.

When patients question why they need to sign this agreement without any drug-abuse history, Echterling said he tells them that the agreement applies to everyone because future addictions are difficult to predict.

"We realize it's a hassle, but it's for their safety," he said. "If it's too much of a hassle, we tell them we have other treatments available."

State Rep. Seth Grove, R-Dover Township, said hearing from the doctors showed him that the medical field is taking this issue seriously.

He said opioid addiction doesn't necessarily require a major legislative fix, but lawmakers can do more to promote better cooperation between groups, including hospitals, recovery centers and law enforcement.

Pain management: Patient satisfaction was brought up several times during the panel as legislators questioned why American doctors disproportionately prescribe opioids compared to other nations.

Dr. Susan Peck, of Hanover Hospital, opined that medical facilities are paid, through legislative initiatives, to not allow pain, and that has led to a growth in opioid prescriptions.

Echterling explained that Medicare funding is partially tied to patient surveys, and patients who feel their pain wasn't addressed in a timely manner can hurt those ratings.

"Those situations are hard because we greatly value our patients' input, but we're pledged to do no harm," he said. "Patient safety comes first."

— Reach David Weissman at dweissman@yorkdispatch.com or on Twitter at @DispatchDavid.

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