On April 28, approximately 200 people gathered at the Seaside Convention Center to discuss the issue of chronic pain, opioid prescribing, opioid dependence and addictions. There were representatives from the medical community, as well as pharmacy, dental, behavioral health, addictions law enforcement, education and interested citizens. We heard a call to action for health care prescribers and all stakeholders to move forward on this important issue. Health experts from around the state presented various clinical updates and recommendations. The CPCCO Clinical Advisory Panel, Opioid Task Force presented its recent recommendations regarding opioid prescribing for chronic pain, which is outlined above. There were breakout sessions to discuss various topics more in depth, as well as to develop action items to create change.
Please see agenda below
Please see the presentation links
Next steps (this is not an all-inclusive list, but examples of some of the outcomes of the summit):
- Reducing the number of pills in circulation - better prescribing:
- The Clinical Advisory Panel Opioid team recommendations were approved and funded. CPCCO staff and regional leaders will work together to being implementing the recommendations, as described above.
- We will be convening a regional discussion regarding specialty and short-term prescribing to include dentists, pharmacists, surgeons, OB/GYNs, ED clinicians and other key stakeholders. Agreement on these guidelines will be important in stopping the cycle of prescribing opioids for pain.
- We will convene discussions with dental, primary care and ED representatives to talk about improving workflows and referral pathways as an avenue to decrease ED visits and opioid prescribing for dental pain.
- Continuing to assess and expand alternative options for pain
- Educating the public about the problem
- We will start to develop community education campaigns regarding acute vs. chronic pain and the risks of opioids. We will engage community members, public health and key stakeholders in developing this campaign. It can include things such as:
- Regional website
- Billboards and other marketing venues
- Posters, pamphlets, patient education handout for ED clinicians and clinics
- Radio and newspaper ads
- School-based events
- Expanding access to treatment of opioid disorders
- We are currently encouraging ALL primary care clinics to continue with and/or move forward with integrated behavioral health. There are good funding options for this and support for implementation and processes. An integrated behaviorist CAN help with the difficulties of working with patients who have chronic pain.
- Columbia Pacific CCO is funding the expansion of OHSU Scappoose medication assistance treatment program. This will be a HUB and Spoke model, which means OHSU Scappoose will be able to provide support services and prescribing, as indicated for the rest of the region.
- We will be conducting regional addictions and MAT trainings in late 2016 and early 2017
- Addictions and behavioral health providers within the region will continue to be a vital part of this important discussion.
- Local pharmacists will work to start stocking this medication, prescribing and training community members on usage
- Primary care will start to evaluate trainings and processes to co-prescribe
- Law enforcement will start and/or continue to develop systems to use this important medication in a lifesaving manner
- Community education events already are happening and will continue
- Better disposal:
- Many local pharmacies have committed to moving forward with drug take-back boxes
- Community education will be an important factor in the success of this effort.
North Coast Regional Steering Committee:
An important outcome of the Opioid Summit was the creation of a regional steering committee to help guide this work and move it forward.
The members of the steering committee are:
- Sarah Present MD, MPH: Columbia County Public Health Officer, Columbia County
- Katrina McPherson MD: Vice President of Operations, Columbia Memorial Hospital, Clatsop County
- Chris Laman, PharmD: Director of Pharmacy, Columbia Memorial Hospital, Clatsop County
- Debbie Morrow: Community Leader, Clatsop County
- Marge Joza: CEO Rinehart Clinic, Tillamook County
- Kate Pillar: Clinic Manager, OHSU Scappoose, Columbia County
- Safina Koreishi MD MPH: Medical Director of Columbia Pacific Coordinated Care Organization
- Adjunct Member: David Labby MD PhD: Health Strategy Officer and former CMO of Health Share
Leslie Ford: Director of Clinical Innovations, Greater Oregon Behavioral Health, behavioral health representative
Alyssa Franzen: Director, CareOregon Dental