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Crowd for opioid symposium exceeds expectations

September 9, 2018

BULLHEAD CITY — Efforts to prevent, intervene, and help provide treatment for and recovery from opioid abuse were topics discussed during an Opioid Symposium at Mohave Community College on Saturday.

The head count well exceeded the 100 RSVPs made by community members interested in the topic but there were enough chairs, coffee and food for everyone who came to listen and ask questions.

Some local physicians and other care providers talked about how they treat patients who depend on opioids for ailments, especially chronic pain.

Dr. Benjamin Venger, medical director of TriState Pain Institute, was the keynote speaker of the symposium. He explained how today’s opioid crisis came about.

He pointed out that it has a long history in the practice of medicine. Opium was a common pain reliever during the Civil War, and was used in the field by soldiers during World War II. It has been used to relieve pain, rheumatoid arthritis, during operations as well as to treat wounds and diarrhea. It was even used to treat addicted patients, Venger said.

The late 1970s marked the debut of Vicodin and Percocet. And the 1980s started with reporting of a retroactive analysis about treatment of chronic pain with narcotics. The analysis of nearly 12,000 patients resulted in the determination that “the development of addiction is rare in medical patients with no history of addiction.”

By that time the opioid epidemic was well under way, Venger said.

Doctors were mandated to provide more pain medication when a patient requested it.

“And if they didn’t, they could be in front of a medical board,” Venger said.

Purdue Pharma got into big trouble for aggressive marketing of oxycontin, a semi-synthetic opiate, which it created in the

mid-1990s. A study published in 2012 showed that 76 percent of those seeking treatment for heroin addiction started by abusing pharmaceutical narcotics, especially oxycontin, Venger explained.

Physicians who came to rely on opioids for their patients became the focus of scrutiny, especially those who specialize in primary care. Venger stated that these doctors really weren’t to blame for overprescribing because they were trained to take pain seriously.

“They were doing what research told them,” he noted.

Today, doctors are cutting back on patients’ narcotic dosages — people who have been legally treated. The state passed rules and guidelines about how to treat patients with opioids.

Venger talked about one of the new practices in Arizona regarding opioid prescribing: “I get a report card every three months.”

And the new Prescription Monitoring Program tracks prescribing and dispensing of opioids. Not every provider participates, however, he said.

“It has to reflect intent, not just numbers.”

Pain clinics, such as his, soon will be required to be certified.

“The FDA is talking about cutting the supply by 10 percent,” Venger said. “But pharmacists have to have it.”

The result is that patients can have a hard time obtaining needed opioids and may need to travel long distances to obtain prescriptions.

More than a dozen experts spent hours explaining what they do and how their efforts assist in providing portions of the local safety net for those who have become dependent on opioids. That safety net includes first responders, people involved in the area’s court system, medical care providers, counselors and other mental health professionals.

Morning panel discussions were led by Dr. Danny Pirtle, senior lecturer of criminology and criminal justice at Arizona State University’s Lake Havasu City campus.

He noted that prevention is important but often not given as much attention as intervention and treatment-recovery because it’s a focus that can keep people from needing intensive help later on.

Doctors and other care providers talked about prevention. Intervention speakers came from the Bullhead City Police and Fire departments, Valley View Medical Center and Mohave County Superior Court. The group representing treatment-recovery included care providers and a person in the public eye who went through treatment-recovery.

Sup. Hildy Angius said she dealt with alcohol addiction for years and decided in late 2006 to get treatment. Her husband struggles with pain management issues after years of physical labor and is wheelchair-bound.

“We need a detox center in Bullhead City,” she said.

In the afternoon, people interested in asking more specific questions could participate in short meetings with a couple of experts at a time. These lasted about 15 minutes each.

A grant awarded to the Mohave Area Partnership Promoting Educated Decisions paid for much of the event. MCC-Bullhead City and Arizona State University-Lake Havasu City are the presenters of the symposium.

Other organizers included TriState Pain Institute and WestCare.

Nancy Mongeau, BHHS Legacy Foundation’s vice president of program development for the Tri-state region, spoke at the beginning and then stepped in to sit on one of the panels. Her background includes years as a registered nurse. She noted that the organization she represents will be helping efforts to reduce opioid addiction in the Tri-State by donating money to local groups and other entities involved in such endeavors.

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