NCAD West: Prescription Opioid Misuse Drops, but Providers Need to Stay Vocal

“We’re making progress,” Robert Valuck, PhD, RPh, FNAP, told attendees Thursday at the National Conference on Addiction Disorders West in Denver, “but we need to make more, and we need to make it faster.”

In an overview on the state of addiction treatment during Thursday’s opening plenary, Valuck, director of the Colorado Consortium for Prescription Drug Abuse Prevention, noted that, per National Survey on Drug Use and Health data, 9.9 million Americans self-reported misusing prescription pain relievers in 2018, a decrease from 11.4 million the prior year. This was the first decrease observed in two decades, Valuck said.

Opioid prescribing is decreasing as the dangers of overprescribing are becoming clearer, Valuck said. To that point, he noted that friends or relatives being prescribed a pain reliever by a single doctor accounted for 83.2% of self-reported prescription pain reliever misuse, according to NSDUH.

Valuck also advocated for treatment facilities to offer buprenorphine, naltrexone and methadone as options. No single medication is best for all patients, Valuck said, so there is value in offering options so that providers can work with patients to figure out what works for them.

Valuck closed with four calls to action for attendees:

• Whether it is stigma, barriers, lack of knowledge, inadequate systems or outdated laws, fight anything in your way to providing better treatment. “Be abrasive. Be whatever you have to be to advocate,” he said.
• Continue to study what works and what doesn’t. “Our work deserves scrutiny,” Valuck said. “It’s our collective responsibility.”
• Continue learning from your peers.
• Follow the evidence. Do what is proven to work, regardless of personal bias.

Personal story drives senator’s push for public good

By her own admission, Colorado state Sen. Brittany Pettersen has always had empathy for those battling addiction, but it wasn’t until navigating every painful step of the state’s process for helping her mother through a 30-year battle with addiction that she understood the barriers along the way.

Pettersen kicked off Thursday’s opening plenary by chronicling her mother’s journey—which has finally culminated in two years of sobriety as of August—and credited attendees of the National Conference on Addiction Disorders West for the diligent work they have been doing “in a system that doesn’t work for you or your patients.”

Like many who battle substance use disorder, Pettersen said her mother’s struggles began with the overprescription of opioids following a back injury. Trips to the methadone clinic in downtown Denver eventually gave way to alcohol before Pettersen’s mother found a new doctor to prescribe opioids. She eventually turned to heroin.

After her mother overdosed 20 times in one year, Pettersen said she worked with treatment professionals to find a solution. A court order held Pettersen’s mother in an intensive care unit until she was taken by ambulance and then, for the first time after 30 years of substance abuse, exposed to a full continuum of care that included detox, residential treatment and inpatient treatment.

Pettersen said changes in her mother were evident after two months in treatment.

“It was like meeting her for the first time,” Pettersen said. “Your brain begins to heal. You start to come back to the person you really are.”

Pettersen outlined some of the initiatives in Colorado she currently is working on to expand access to treatment, including a Medicaid expansion waiver that will complete the state’s continuum of treatment services by adding residential and inpatient SUD services as covered services. The waiver, which would be implemented next summer, is pending federal approval.