Last month UNM established an official partnership with Indian Health Services (IHS), in an effort to further combat the opioid-misuse epidemic plaguing the nation - notably within the Native American community - who are disproportionately affected by instances of opiate abuse in people 12 years and older.
The partnership utilizes ProjectECHO, a telehealth service provided by UNM.
For the past three years, the collaboration has existed on more of an informal basis, but as of last month this has changed, said Joanna Katzman, director at the UNMH Pain Center.
“We’ve really formalized the collaboration through what’s called an ‘interagency agreement,’ it’s a special thing,” she said. “That means that our (diverse) Pain Center faculty are now really considered the subject matter experts for the IHS when it comes to pain and addiction, throughout the country,” she said.
Prescription opioid misuse occurs when patients use their medications for reasons other than those for which they were prescribed, or when they weren’t prescribed at all, she said.
In the United States, 4.2 percent of the general population 12 years of age or older misuse prescription opioids, Katzman said. For the Hispanic community, considered to be one in isolation, this figure becomes 4.9 percent, she said. The American-Indian population misuses at a rate of 6.9 percent.
“That’s a much higher rate of opioid misuse,” she said. “If we can educate the clinicians, the doctors, the nurse practitioners, the physician’s assistants, the psychologists and mental health providers (on) how to take care of their patients more safely, then they also would be able to (educate), treat their patients more safely.”
For instance, this education emphasizes proper screening techniques on the part of prescribers, and increased awareness of alternative pain-killing methods, Katzman said.
“How to screen patients for opioid misuse, for addiction,” she said, “Many patients who come into their primary care doctor for chronic pain, they don’t necessarily need a prescription for Vicodin, or Percocet or an (opioid) painkiller. They might benefit from physical therapy, acupuncture, Motrin, Advil.”
Being that 100 million Americans suffer from some sort of chronic pain, it is important that the medical community strike a balance between safe opioid-prescribing and patients who are actually in need of such medication, Katzman said.
“There’s a huge epidemic of chronic pain in America,” she said. “With situations like this, with epidemics of drug overdoses, we always have to balance the unintended consequences of curtailing things like opiates that might be beneficial in patients with chronic pain.”
There are instances in which prescribing opioids can be justified, but at the same time, there are other prescribing practices can be adopted, such as modified dosages and amounts of pills, Katzman said.
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“New Mexico is now the second highest state in the country for drug overdoses,” she said. “In the past decade, we’ve been in the top three (nationwide) for opioid overdoses. We’ve always ranked very, very high. We’ve really just always battled a prescription and Heroin epidemic in New Mexico.”
Methamphetamines are also a contributing factor to the drug-related death toll, and it is unclear why our state suffers so greatly with this issue, Katzman said. Although, from 2012-2014, the rate of drug overdose (including those involving methamphetamines) within New Mexico actually decreased, possibly for two reasons, she said.
“One is, New Mexico was one of the very first states in the country to mandate clinician education, to mandate that all clinicians who could prescribe opiates had to get training. Training like we’re now giving to IHS, our Pain Center also delivered to all clinicians in New Mexico as well,” she said.
Second, the New Mexico Medical Board also mandated that physicians and physician’s assistants used the Prescription Drug Monitoring Program.
“Meaning that every time they go to prescribe an opioid, they needed to look on a website and see ‘Is this patient getting their prescriptions from any different doctors, many different refills?’ things like that,” she said.
Unfortunately, last year witnessed an uptick in the rate of drug overdose deaths, Katzman said. However, the rise seems to be primarily related to methamphetamine overdoses.
There are many different, equally effective pain-killing drugs that are far less addictive than opioids.
“A lot of doctors might not feel comfortable going to them (at first). We’re trying to increase their comfort level,” Katzman said.
Johnny Vizcaino is a staff reporter at the Daily Lobo. Contact him at news@dailylobo.com or on Twitter @thedailyjohnnyv.
