Prescription drug abuse

Saturday, September 01, 2018 12:20 PM
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Colorado Consortium for Prescription Drug Abuse Prevention hosts education symposium on Oct. 24

by Michael Davidson, Communications Professional, Colorado Consortium for Prescription Drug Abuse Prevention

It’s hard to find good news when discussing the opioid crisis – but for health care providers looking to make a difference, there are reasons for hope. A renewed focus on multimodal, integrated pain management can provide patients with effective pain relief, and Colorado providers are ramping up treatment capacity for people with opioid use disorders.

Those are messages Lesley Brooks, MD, and Josh Blum, MD, would like to share with health care providers across Colorado. Brooks and Blum are the co-chairs of the Provider Education work group for the Colorado Consortium for Prescription Drug Abuse Prevention.

The Consortium is hosting the first Colorado Consortium Education Symposium: Best Practices for Pain Management and Addiction Treatment on Wednesday, Oct. 24. This free event at the University of Colorado Anschutz Medical Campus in Aurora is for physicians and other providers who want to learn the latest in evidence-based pain management and opioid addiction treatment. Registration information is available at

Continuing medical education credits are available for MDs and DOs. Certificates of completion will be available for all others.

Unfortunately, the need for better prevention and treatment strategies increases. Although fewer prescriptions for opioids are being written, the overdose death toll increases. According to the Colorado Department of Public Health and Environment, 560 people died of opioid overdoses in Colorado in 2017, up from 504 in 2016 and 108 in 1999. A total of 1,112 people died of overdoses in Colorado in 2017, up from 1,032 in 2016 and 432 in 1999.

Useful information about opioid alternatives

The goal of the symposium is for health care providers to leave with valuable information they can incorporate into their practices. The event will feature keynote presentations and focused breakout discussions about non-opioid pain management and best practices for treating addiction.

“We’re learning more and more about pain relief and ways to address substance use disorders. Much of it is applicable to how we can treat patients in our emergency rooms and offices,” said Blum, a primary care and addiction specialist at Denver Health who works with opioid and injection drug users. “We need to get the word out.”

One big lesson is that non-opioid analgesics work for many forms of acute pain. A study published in the Journal of the American Medical Association (JAMA) in 2017 showed that a combination of ibuprofen and acetaminophen was as effective as oxycodone, hydrocodone and codeine when it came to relieving acute pain caused by an arm or leg sprain, strain or fracture.

Another JAMA study published in 2018 showed that treatment with opioids was not superior to treatment with non-opioid medications for improving pain-related function over 12 months for moderate to severe chronic back pain or hip or knee osteoarthritis pain.

Instead, holistic approaches that include topical treatments such as ice, heat and massage, movement therapies like yoga and tai chi, psycho-behavioral therapy and complementary modalities including acupuncture all play a role in pain management.  Among other references, a 2017 back pain guideline from the American College of Physicians  highlights this approach.

Treatment approaches that don’t involve medication, such as physical therapy, cognitive behavioral therapy and yoga are also effective.

Better options for treating opioid use disorders

Helping patients avoid opioid use disorders is ideal, but providers also have tools to help patients who have developed disorders.

“Medication-assisted treatment is proven to save and improve lives. Patients and physicians have more options now, such as buprenorphine and naltrexone, which are game changers in addiction treatment,” Brooks said. Brooks is a family medicine physician in Greeley where she serves as the chief medical officer for Sunrise Community Health and assistant medical director for the North Colorado Health Alliance. She led the implementation and manages the medication-assisted treatment (MAT) program at Sunrise Community Health.

The symposium will cover those medications in depth, highlight how providers can be trained to administer MAT, and share practical information doctors can use to incorporate MAT into their clinics.

“An important thing to know about these medications is we can prescribe them or administer them from our offices,” Brooks said. “That greatly simplifies the treatment process both for us and our patients.” And they are effective. Administered within a structured environment, methadone, buprenorphine and naltrexone lead to decreased relapse rates and all-cause deaths, decreased acquisition of infectious diseases and, most importantly, increased retention in treatment.

Physicians who want to offer MAT need to complete eight hours of training and advanced practice providers need 24 hours of training to receive a waiver allowing them to prescribe buprenorphine.

“The training and waiver process is easy to complete and we offer guidance to physicians who are interested. We don’t want that to be a barrier for anyone,” Brooks said.

Symposium speakers also will cover the latest scientific research about use disorders and treatment best practices.

Attendees who want more information about the state’s response to the opioid crisis are welcome to attend the Colorado Consortium for Prescription Drug Abuse Prevention’s annual meeting the next day, Thursday, Oct. 25.

Posted in: Colorado Medicine | Initiatives | Prescription Drug Abuse


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