Western Carolina RIMS presentation summary June 2018 Meeting The - - PDF document

western carolina rims presentation summary june 2018
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Western Carolina RIMS presentation summary June 2018 Meeting The - - PDF document

Teresa Bartlett, MD Senior Vice President and Senior Medical Officer Sedgwick Western Carolina RIMS presentation summary June 2018 Meeting The Opioid Epidemic a Perilous Drug Crisis How did we get here? Purdue Pharma Congress passed law


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Teresa Bartlett, MD Senior Vice President and Senior Medical Officer Sedgwick

Western Carolina RIMS presentation summary June 2018 Meeting The Opioid Epidemic a Perilous Drug Crisis How did we get here?

  • Purdue Pharma
  • Congress passed law late 2000 decade of pain control
  • Addictive properties not well understood
  • How opioids impact the brain Mu receptors

Statistics from the CDC

  • 115 people die each day
  • Economic burden estimated at $78 Billion
  • Reduced male workforce by 20%
  • Added over 92,000 children to foster care system
  • Those addicted to prescription opioids are 40% more likely to become addicted to

heroin

  • Long term use statistics
  • 1 day = 6.0% on opioids 1 year
  • >8 days = 13.5% on opioids 1 year
  • >31 days = 29.9% on opioids 1 year
  • 90 days = 60% 5 years later

Kratom Carfentanil States respond to opioid crisis

  • 11 states have adopted formularies and many more to come
  • 29 states have passed limits on the first fill of an opioid
  • Some states require physicians to check the PDMP before prescribing an opioid
  • CARA Act has been adopted to allow partial fill of schedule II medications such as
  • pioids

Beware of dangerous drug combinations

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  • Importance of knowing all medications a person is taking

BEERS criteria for those age 65 and older who have difficulty metabolizing medication Lock all medications in a lock box even those medications you think are not dangerous Opioid induced constipation Understand the impact of the BioPsychoSocial model in workers’ compensation Adverse Childhood Events and all the research points to the potential for delayed recovery and addiction issues We must change our emphasis to focus on pre-injury and pre-pain and find alternatives to

  • pioids

Alternatives include

  • Stress management
  • Deep breathing techniques
  • Yoga
  • Acupuncture
  • Chiropractic
  • Pet therapy
  • Mindfulness

Marijuana is now recreationally legal in 9 states

  • Medical marijuana is legal in 29 states and that number is growing by the day
  • Not a good replacement for opioids
  • Side effects:

▪ Anxiety ▪ Hypertension ▪ Many people present to Emergency rooms with symptoms of heart attacks ▪ Not federally legal “We know of no other medication routinely used for a non-fatal condition that KILLS patients so frequently” Dr. Tom Frieden, Former Director of the CDC

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