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Pulling back the curtains on wage-theft enforcement in MN; Trump's latest attack is on RFK, Jr; NM LGBTQ+ equality group endorses 2024 'Rock Star' candidates; Michigan's youth justice reforms: Expanded diversion, no fees.

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Pain Management Clinics Work to Stem OR's Tide of Drug Overdoses

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Wednesday, June 11, 2014   

ASTORIA, Ore. - A new pain-management clinic in Astoria is the latest step in a statewide effort to curb an epidemic of pain medication abuse in Oregon.

The state is ranked first in the nation in deaths from pain prescription overdoses. Many drugs prescribed legally for chronic conditions lead to addiction or are diverted to other users illegally.

The North Coast Pain Clinic integrates traditional medicine with physical therapy, psychological services and non-drug methods of easing chronic pain. Mark Altenhofen, project manager, said it's an alternative not only for patients but for doctors wary of prescribing painkillers.

"We're seeing docs say, 'Well, I'm not treating pain at all,' in some cases," he said. "And it's really sad, because the prescription is just one part of the tool. Even in primary care, you can still support that patient even if you decide not to prescribe. There are other ways to help address the issue."

From 2000 to 2012, according to a state report, almost 4,200 Oregonians died of an unintentional or undetermined drug overdose, and more than 15,000 were hospitalized. It recommended early identification of people with addiction problems, and better coordination of behavioral and physical health care.

Dr. Anne Alftine said Coordinated Care Organizations such as Columbia Pacific on the North Coast or Jackson CareConnect in Medford, where she works as director of clinical strategy, are serving as catalysts to integrate the different types of care. One goal is to work more closely with addiction treatment providers. In much of the state, Alftine said, they're in short supply.

"It's been under-funded for a number of years," she said, "and that's one of the things we're looking at: How do we partner with them in better ways, in connecting primary care and addiction services? How do we work together as partners, in helping these patients get the care that they need?"

According to a national survey on drug use and health, only about one in 10 people who need specialized substance abuse treatment get it from a specialized facility. Alftine said that's more proof of the need for coordinated care.

Dr. Jim Shames, medical director for Jackson County Health and Human Services, said Oregon is taking other innovative approaches to keep people from becoming hooked on painkillers - but real progress requires a cultural shift, for patients and doctors.

"We really have to change the way we think about the management of chronic pain - of pain in general," he said. "It requires public messaging, physician messaging. It's a big issue and it runs deep, but the consequences of not getting it right are pretty severe. It's killing us."


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