Healthcare providers from Utah County gathered on April 4 to learn how they can help reduce the non-medical use of pain killers.
The Utah County Substance Misuse and Abuse Reduction Team (SMART) trained doctors, physician assistants and nurse practitioners at the Central Utah Clinic in Provo on how to refine their pain pill prescribing.
Clarene Hansen, a nurse practitioner, said she attended the training because part of her job requires her to help prescribe pain medication.
“There’s a lot of requests in Utah for pain killers,” Hansen said. “I want to make sure we are doing it wisely.”
Dr. Henry Gardner, a SMART coalition member who presented the training, said Utah County has one of the highest rates of non-medical pain pill use in the country.
“Half of the LaVell Edwards football stadium could be filled with Utah Valley residents who are using pain medication non-medically,” Gardner said.
Dr. Stephen Nelson, another SMART coalition member, said pain pills can greatly aid in the recovery process when used properly.
“In some cases, however, patients abuse or unknowingly misuse their prescriptions which can lead to addiction,” Nelson said.
Kaye Nordfelt, SMART Coalition Coordinator, said SMART found in focus group and community studies that patients were often being over-prescribed pain pills with little or no instruction on how to safely use, store and dispose of leftover medication.
“Most physicians freely admitted the time spent counseling patients about prescription pain medication was minimal or sometimes nonexistent,” Nordfelt said.
Gardner said in the late 20th century, healthcare consumers began to feel medical science was really able to relieve all their pain.
“If you give someone anesthesia, they won’t feel any pain, but the problem is they can’t function,” he said.
Gardner said people who have severe pain also are inhibited physically.
“There is a conflict between function and pain relief,” Gardner said. “So if you can improve their function, even though they may still have some pain, that really should be your goal.”
He said tolerance to these medications can happen very quickly.
“Young people need to realize that there is no really easy solution and using opiates is a big deal,” Gardner said. “You should avoid using those medications unless they’re truly indicated and you can encourage your providers to try something else before you have to go down that pathway.”
Gardner presented five practices for safe opioid prescribing in the training:
- Prescribe fewer pills
- Start low, go slow
- Know your patient’s risk
- Educate patients/family
- Recognize abuse/addiction/dependence and intervene
Gardner said pain pill abuse is a complicated problem involving many factors.
“One of the issues with this is our decision making as physicians,” he said, “especially if we prescribe more opiates than are needed that are leftover in the medicine cabinet where young kids can find and use them.”
Gardner said in 2007, more young people died from pain pill overdose than from automobile crashes.
“Together we can prevent pain pill abuse,” he said, “but it’s going to take a concerted effort.”