Norwich — Concerned that a possible surge in patients unable to get opioid prescription refills will turn to illegal drugs such as heroin or fentanyl, the city’s Human Services Department is offering to help residents find addiction treatment and urging them to seek medical care.

“We’ll troubleshoot it,” Lee Ann Gomes, Norwich human services director, said Friday. “We’ll try to help the best we can.”

Gomes and Angela Duhaime, coordinator of the city’s Partnership for Success Program, said Friday they became concerned that the opioid crisis could worsen after Dr. John Paggioli of the Eastern Connecticut Pain Treatment Center surrendered his federal and state permits to prescribe narcotics.

He surrendered his permit to prescribe narcotics to both the state consumer protection department and the federal Drug Enforcement Agency on Dec. 15, according to officials at the state Department of Public Health. He was placed on probation by the consumer protection department in December 2015, and has been fined by that department and the Connecticut Medical Examining Board for violations of prescribing practices. An investigation by the state Department of Consumer Protection into his prescribing practices is ongoing.

Paggioli, who practices at an office on West Town Street, is one of the region’s few pain management doctors, so the sudden shutting down of his opioid prescribing services means that some local residents may be searching unsuccessfully for another doctor to refill prescriptions, they said.

In a Dec. 19 letter, Paggioli advised his patients to find another doctor if they need narcotic pain medications, including seeking care from their primary care doctors. He advised them to go to a hospital emergency department if they start experiencing withdrawal symptoms.

There are just four other pain management physicians in the Norwich-New London area.

“There are a very limited number of pain specialists in the area, and many primary care doctors are not trained in that area,” Duhaime said. “We’re trying to be proactive.”

“If the person has a legitimate need for pain medications and now they’re cut off, it can be terrible,” Gomes added. “If they start experiencing withdrawal symptoms, we don’t want them to start using heroin.”

She and Duhaime said they have been contacting primary care doctors and other medical providers in the area to alert them to the situation. They also are prepared to provide information to city residents about treatment services that can help wean them off prescription opioids.

Thus far, patients of Dr. Paggioli’s have not been seeking care at the emergency departments at either The William W. Backus Hospital in Norwich or Lawrence + Memorial Hospital in New London, according to officials at both hospitals.

Dr. Oliver Mayorga, chairman of the L+M Emergency Department, noted that if a patient came for an opioid prescription refill to avoid withdrawal symptoms, the hospital would only be able to give a one- or two-day supply.

At Backus, patients seeking opioids for pain management are advised to seek care from their primary care doctor, said Steve Coates, spokesman for Backus. Those without primary care doctors are referred to one in the hospital’s network, or to the MATCH addiction treatment program.

Norwich human services officials are also referring people to MATCH, Medication Assisted Treatment Close To Home, which has a local office in Groton.

Dr. Ramindra Walia, chief medical officer of United Community & Family Services, said three or four patients of Dr. Paggioli have called the Norwich clinic in recent weeks. They have been told to enroll as patients with a primary care doctor there and to come in for an evaluation, he said.

“We do have a holistic pain management policy,” he said.

In his letter to patients, Dr. Paggioli said his office remains open to provide pain management treatments that do not involve narcotics.

Dr. Paggioli’s staff referred questions and a request for comment to his attorney, Hilary Fisher Nelson.

"Dr. Paggioli remains concerned about the impact the change in his practice has had on his patients," she said in an emailed statement. "To facilitate ongoing treatment, on December 20, 2016, Dr. Paggioli mailed letters to his impacted patients notifying them of the change in his practice and recommending options for how to proceed if they require pain medication going forward."

j.benson@theday.com

Norwich residents seeking help with an opioid prescription problem can call:

Lee Ann Gomes, human services director, (860) 823-3778

MATCH (Medication Assisted Treatment Close to Home): 1353 Gold Star Highway, Groton, (860) 449-9947

SCADD (Southeastern Council on Alcohol and Drug Dependence), (860) 889-3178