First use Non-Steroidal Anti-Inflammatory Medications- NSAIDS
-Don’t underestimate ibuprofen- it helps with pain in lot of cases.
-Use local anesthetics.
-when NSAIDS do not help, use opioids for a short term
– Don’t use long-acting opioids
Opioid Addiction: Basic Facts
-7 people a day die of opioid addiction in Pennsylvania alone.
-chronic non-cancer pain is real.
-over 16000 deaths per year in the United States.
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Follow prescribing guidelines.
-Chronic Pain is a major health problem. It disturbs their daily life, work and functionality.
-Acute pain starts suddenly, may stop after a few weeks.
-Doctor shopping is on the rise.
-State limitations:
– each prescription is issued for a legitimate medical purpose.
-people addicted to opioids are 40 times more likely to use heroin.
-Pills are for Ills, Not thrills: go to the website
Projectlazarus.org
-to treat pain, use physical therapy, cognitive behavior therapy beside medications.
-Understand the risks and benefits of opioid treatment
-Get Opioid Treatment Agreement
-Sign the Contract
-Do random urine drug screens
-don’t use marijuana or other street drugs
-Don’t divert your medication.
-Good moral values also help: Don’t lie or steal.
Acute Pain and Opioids
We should treat acute pain.
-First consider non-opiate analgesic.
-In the Emergency Room, don’t prescribe opioids for more than 7 days
-Prescription abuse is a national problem. It is getting worse in Pennsylvania.
-Red Flags: poorly defined injury, refusing non-opiates, refusing labs, insists on which medication works best, well-rehearsed story.
-Lost medication: In most cases, it is not lost.
– Document your treatment plan.
-Use controlled substance database.
– educate patient about the complications of opiates
Child Abuse Penalties in Pennsylvania: Failure to Report
- Mandated reporters are required by law to report when they have reasonable cause to suspect a child is the victim of abuse
- A mandated reporter who willfully fails to make a report of suspected child abuse could face legal penalties, including fines and/or incarceration
- These penalties increase with repeated violations
23 Pa. C.S. § 6339. § 6319. Penalties.
(a) Failure to report or refer.–
(1) A person or official required by this chapter to report a case of suspected child abuse or to make a referral to the appropriate authorities commits an offense if the person or official willfully fails to do so.
(2) An offense under this section is a felony of the third degree if:
(i) the person or official willfully fails to report;
(ii) the child abuse constitutes a felony of the first degree or higher; and
(iii) the person or official has direct knowledge of the nature of the abuse.
(3) An offense not otherwise specified in paragraph (2) is a misdemeanor of the second degree.
(4) A report of suspected child abuse to law enforcement or the appropriate county agency by a mandated reporter, made in lieu of a report to the department, shall not constitute an offense under this subsection, provided that the report was made in a good faith effort to comply with the requirements of this chapter.
(b) Continuing course of action.–If a person’s willful failure under subsection (a) continues while the person knows or has reasonable cause to believe the child is actively being subjected to child abuse, the person commits a misdemeanor of the first degree, except that if the child abuse constitutes a felony of the first degree or higher, the person commits a felony of the third degree.
(c) Multiple offenses.–A person who commits a second or subsequent offense under subsection (a) commits a felony of the third degree, except that if the child abuse constitutes a felony of the first degree or higher, the penalty for the second or subsequent offenses is a felony of the second degree.
(d) Statute of limitations.–The statute of limitations for an offense under subsection (a) shall be either the statute of limitations for the crime committed against the minor child or five years, whichever is greater.
Willful failure to report that continues while you know or have reasonable cause to suspect that child abuse is occurring is considered a misdemeanor of the first degree.
However, if the child abuse is considered a felony of the first degree or higher, this continual failure to report becomes a felony of the third degree.
If you fail to report suspected child abuse multiple times, the offense is considered a felony of the third degree.However, if the child abuse is considered a felony of the first degree or higher, the offense becomes a felony in the second degree.
However, if the child abuse is considered a felony of the first degree or higher, the offense becomes a felony in the second degree.
Pennsylvania’s Child Welfare Practice Model
Pennsylvania’s Child Welfare Practice Model guides children, youth, families, child welfare representatives, and other service partners in working together to ensure:
- Safety from abuse and neglect
- Enduring and certain permanence and timely achievement of stability, supports, and lifelong connections
- Enhancement of the family’s ability to meet their child/youth’s well-being, including physical, emotional, behavioral, and educational needs
- Support for families within their own homes and communities through comprehensive and accessible services that build on strengths and address individual trauma, needs, and concerns
- Strengthened families that successfully sustain positive change toward safe, nurturing, and healthy environments; and
- Skilled and responsive child welfare professionals with a shared sense of accountability for assuring child-centered, family-focused policy, best practice, and positive outcomes
Children exposed to drugs and substances
Tragically, many children are being exposed to dangerous drugs and substances right from their conception, during development in the uterus or since their birth.
The law requires health care providers to report immediately to the appropriate county agency when they deliver or provide care to an infant under one year of age who is affected by:
- the mother’s illegal substance abuse
- withdrawal symptoms resulting from prenatal drug exposure unless the child’s mother, during the pregnancy was:
- Under the care of a prescribing medical professional; and
- In compliance with the directions for the administration of a prescription drug as directed by the prescribing medical professional or
- a fetal alcohol spectrum disorder (FASD)
You should immediately report this to ChildLine to protect the child. This includes all health care providers.
- Physician
- Podiatrist
- Optometrist
- Psychologist
- Physical therapist
- Certified nurse practitioner
- Registered nurse
- Nurse midwife
- Physician assistants
- Chiropractor
- Dentist
- Pharmacist
- Individual accredited or certified to provide behavioral health services
Always Report Suspected Child Abuse
Look for Physical Signs like bruises, burns, cigarette marks, that do not match parent or guardian’s description.
What do you need to make a report of abuse? REASONABLE cause to suspect abuse. You don’t need firm evidence of abuse. Anyone with reasonable cause to suspect abuse should report child abuse.
-Who should report suspected child abuse:
Mandated reporters: Must report suspected child abuse.Required by the Law. Includes all health care workers, foster parents, funeral directors, coroners, coaches (both paid and unpaid), school employees, physical education teachers, online teachers, librarians, spiritual leaders, law enforcement officers, attorneys, anyone with direct contact with children in their employment, independent contractors etc. Call ChildLine immediately.
Permissive reporters: Encouraged to report suspected child abuse.
-ANYONE with reasonable cause to suspect that a child is a victim of abuse should report.
Children of color are overrepresented in the child welfare system at alarming rates.
Visit http://keepkidssafe.pa.gov/ or call ChildLine 1-800-932-0313 to report suspected child abuse.
Great Care At Low Costs 