Hospital leader testifies at Senate hearing on opioid use among seniors

The Senate Special Committee on Aging today held a hearing on opioid use among seniors. Steven Diaz, M.D., senior vice president and chief medical officer for MaineGeneral Health in Augusta, ME, said his hospital’s emergency department saw 10 opiate overdoses in patients age 65 or older last year, more than double the past average. “The treatment of patients with chronic pain is a significant contributor to the epidemic,” he said, adding that “opiates for non-terminal chronic pain, especially in the elderly, should not be first-line treatment.” While primary care physicians and specialists in psychiatry and physiatry “are key for work in the treatment of pain,” he said national shortages of each are amplified in rural areas such as Maine. “Ideally, when a patient presents to the medical system for chronic pain or opioid addiction, whether through their primary care physician, specialist, therapist, emergency department visit or through an interaction with law enforcement, the pathway for intervention and expert clinical support should be readily available,” he said. Diaz also raised concerns about the use of pain queries on the Hospital Consumer Assessment of Healthcare Providers and Systems. Sean Cavanaugh, director of the Center for Medicare at the Centers for Medicare & Medicaid Services, in response to a question from Committee Chairman Susan Collins (R-ME), agreed to consider revising the HCAHPS questions. Also testifying at the hearing were representatives from the Department of Health and Human Services’ Office of Inspector General, Indiana State Department of Health and Stanford University School of Medicine.