Trying to solve the opioid problem in Douglas County
Douglas County surgeons, who often prescribe opioid pain medication for patients recovering from surgery, are trying to find ways to solve the opioid addiction problem in the community by cutting back on the excessive amounts that are given to a patient after surgery. And they say they have made a significant reduction in the amount of drugs that are prescribed.
Dr. Bret Hansen from the Oregon Surgery Center in Roseburg said surgeons have been working for the last year to come up with ways to curb the abuse of prescription drugs. He said it’s obvious that the crisis is the result of prescriptions, so the doctors are the ones who need to make a change.
“The bottom line is the crisis in America is because of prescriptions, and the prescriptions are written by the doctors, so the doctors are the problem,” he said.
So the surgeons and other health professionals in the Professional Management of Oregon, made up of 35 surgeons and anesthesiologists in Roseburg, are working to solve the problem.
In the past, doctors have been encouraged to prescribe more than the patient needs, Hansen said, and that excess is what causes the problems. Either the patient continues taking the pills after they’re not needed any more and that person gets addicted, or the pills get into someone else’s hands, such as kids, and then the kids get hooked on the drugs.
“We’ve just got to decrease the number of pills that are in circulation,” he said.
Dr. Vanessa Vu, an anesthesiologist at the Oregon Surgery Center, said doctors could be reprimanded for not prescribing enough pain medication a few years ago.
“Except for pathologists, we all had to take 10 hours of continuing education on how to prescribe opioids and everybody had to have the education, sanctioned by the state board,” Vu said.
While a certain amount of pain medication is necessary, Hansen said, the doctors don’t want to give out too many. But they also want to make sure the patient has enough to take care of the pain.
“What we want to do if find the sweet spot, and we’re still trying to find what that is,” Hansen said.
The group is still trying to figure out how to install a drug take-back program, but that’s a little complicated to do at the hospital. However, there are drug drop-off sites at Gordon’s Pharmacy in Canyonville and at the sheriff’s office in Roseburg and city police agencies including Myrtle Creek, Winston, Sutherlin and Reedsport. But if it can be worked out, the doctors would like to see one at the hospital where people could bring back the pills they didn’t need and drop them off right there.
“It makes sense,” said Dr. Brad Seely, a Roseburg ophthalmologist and member of Professional Management of Oregon. “You got your prescription here, this is where you bring back those extras that you don’t need.”
Gordon’s Pharmacy in Canyonville is the only pharmacy in the county that has a take-back program in place. And doctors agree that more pharmacies with take-back programs would get a lot of the drugs off the streets and prevent them from being used illegitimately.
Rebecca Wood, the project coordinator for the Oregon Coalition for Responsible use of Medication (OrCRM) said it takes about six weeks to set up a program, and will cost a pharmacy between $800 and $2,000 a year to have a take-back program, depending on the amount of pills collected and the frequency of pick-up. But it can be done, and hospitals or clinics can also do take-backs; however, they need to be associated with a pharmacy.
“We do have a huge problem,” she said. “We don’t want to take away the value of opioids as a legitimate medication for people with some types of pain, but the risks they pose have been drastically underestimated, and their benefits overestimated, and we are now seeing the results.”
Wood said that as of 2013, Oregon had the second highest rate of non-medical use of prescription opioids in the nation and the Oregon Health Authority showed more poisoning deaths involving opioids than any other type of drug in 2013.
“We do know that when people have leftover antibiotics, and then use them, that can lead to antibiotic resistance. The pills could be used accidentally or by people who would misuse them intentionally,” said Dr. Bob Dannenhoffer, a Roseburg pediatrician and the Douglas Public Health Officer. “So we think it’s good when you’re done with the medication and don’t need it any more, just get rid of it.”
Hansen said four out of five heroin users in Oregon begin with pain killers, and 70 percent of those start from a drug cabinet in the home. In Oregon, he said, 110 people died last year from opioids.
“Anything we can do to decrease the pills in circulation is what we want to do,” Hansen said.
Dannenhoffer said much more work remains to solve the problem.
“All the dentists need to do it, the surgeons need to do it and people that are misusing the drugs, really need to get into treatment, and probably the best treatment is medication assisted therapy,” Dannenhoffer said. “It’s a hundred times easier to prevent addiction than it is to treat it.”
Nationwide, Dannenhoffer said they expect that 60,000 people will die of drug overdoses this year, and he said they’re not down-and-out people in the alleys. He said they tend to be white males in their 40s, 50s and 60s who have an injury and get into a cycle of using the painkiller drugs and get hooked.
“We all recognize that it’s a huge problem here, and we are the problem, so we need to do something about it,” Hansen said.