As part of a national effort to address prescription drug abuse, all Emergency Departments in Alameda and Contra Costa counties have voluntarily agreed to adopt safe prescribing guidelines that ensure patients have access to appropriate pain management while reducing the chances for prescription drugs to be misused. The guidelines are intended to establish consistency across Emergency Departments and to help establish expectations about the type of care patients can expect to receive.

Emergency Departments will continue to treat acute pain with limited amounts of pain medications according to diagnosis, but generally will not refill lost or stolen prescriptions or prescribe long acting pain medicines such as OxyContin, MSContin, Fentanyl (Duragesic), Methadone, Opana ER, Exalgo, allowing primary care physicians to provide appropriate ongoing pain management care for patients. EDs also will not dispense missed doses of Subutex, Suboxone, or Methadone. And rather than shots for flare-ups of chronic pain, EDs will instead offer oral medication to address such acute pain occurrences if needed. Emergency Departments will be checking California’s CURES prescription drug database for any other prescriptions for opioid pain medications and/or controlled substances, and patients are encouraged to receive their ongoing pain management care from one physician and one pharmacy.

All 20 Emergency Departments in Alameda and Contra Costa counties that provide care to adult patients have adopted these guidelines:

• Alameda Health System-Alameda Hospital
• Alameda Health System-Highland Hospital
• Alameda Health System-San Leandro Hospital
• Alta Bates Summit Med Center - Alta Bates
• Alta Bates Summit Med Center - Summit Campus
• Contra Costa Regional Medical Center
• Eden Medical Center
• John Muir Medical Center-Concord Campus
• John Muir Medical Center-Walnut Creek
• Kaiser Permanente Antioch Medical Center
• Kaiser Permanente Fremont Medical Center
• Kaiser Permanente Oakland Medical Center
• Kaiser Permanente Richmond Medical Center
• Kaiser Permanente San Leandro Medical Center
• Kaiser Permanente Walnut Creek Medical Center
• San Ramon Regional Medical Center
• St. Rose Hospital
• Stanford Health Care - ValleyCare
• Sutter Delta Medical Center
• Washington Hospital Healthcare System

“The fact that all of the Emergency Departments in the East Bay are following these guidelines will go a long way toward curbing doctor shopping,” says Thomas Sugarman, M.D., an emergency department physician who serves as Co-Chair of the East Bay Safe Prescribing Coalition ( and is Secretary Treasurer of the Alameda-Contra Costa Medical Association. “The guidelines establish a common set of standards that patients can expect, and that are in the interests of their overall and ongoing health.”

In California, deaths involving opioid prescription medications have increased 16.5 percent since 2006. In 2012, there were more than 1,800 deaths from all types of opioids – 72 percent involved prescription opioids. In 2014, opioid related deaths increased by 50 percent from 2012.

The Emergency Department guidelines were developed by California emergency physicians and endorsed by numerous medical organizations and have been promoted locally by the East Bay Safe Prescribing Coalition, which is co-sponsored by local organizations that represent the medical community: Alameda-Contra Costa Medical Association (ACCMA), Hospital Council of Northern and Central California, Alameda County Health Care Services Agency, Contra Costa Health Services, and the Alameda Health Consortium. The Coalition in managed by the ACCMA, with funding from the California HealthCare Foundation.

For more information, contact:

Joe Greaves
Asst. Executive Director
Alameda-Contra Costa Medical Association
6230 Claremont Ave, 3rd Flr, Oakland CA 94618
p: 510-654-5383
f: 510-654-8959