NEW ALBANY — A panel of physicians, counselors and others who work directly with opioids and addiction spoke Friday at IU Southeast in New Albany, the Addiction Coalition of Southern Indiana's first such event to help educate the public on the realities of the growing opioid crisis.
Dr. Saeed Jortani, director of Clinical Chemistry and Toxicology and professor of Pathology and Laboratory medicine at University of Louisville School of Medicine spoke on post-operative pain management and the research into individual response.
Patients reporting pain make up 80 percent of physician visits in the U.S. annually, he said. This accounts for $328 million in prescriptions each year. Chronic pain affects 100 million people and $600 billion is spent annually on health costs and lost wages. Yet 4.5 million die each year in pain.
Researchers at U of L are working on a project to determine the role genetic makeup plays in how a person receives opioids and individual response to pain; this will help prescribers know the type and dosage — if an opioid is used — will be effective while minimizing risk.
This project, funded by a $1.6 million grant from the U.S. Department of Defense, was launched in February, however the laboratory self-funded the research needed to get the pilot data for the past 10 years. They will study one opioid at a time, starting with hydrocodone.
“It will allow us to build an algorithm for pain relief before the patient goes through surgery,” he said. You could have that [testing] done if you'r pregnant and expecting to undergo operations, knee replacement...and especially for the soldiers before they are deployed. So when they get back, they don't have to be basically experimented with on [their] pain management.
“Because that is very dangerous. That can lead to chronic pain, PTSD,” he said.
He said the findings could potentially speak to a person's likelihood of developing an addiction to the medication.
“If you give the right medication to the right patients, the chances of addiction, side effects decrease and chance of efficacy and pain relief goes up, which is basically what you want.”
Keynote speaker Dr. Edwin Salsitz, who works in the division of chemical dependency at Mt. Sinai Beth Israel Hospital in New York, spoke on addiction itself, including the environmental factors that can play a role in potential addiction.
Saturday morning, he led a course in safe and effective opioid prescribing for area practitioners who prescribe them. The class, known as a Risk Evaluation and Mitigation Strategy course, follows the Centers for Disease Control and Prevention guidelines published in March 2016 for responsible prescribing.
“What we hope to get out of this is if providers do choose to prescribe opioids, they will do it in a safe, reasonable manner to get as much benefit they can from it with the least risk and harm,” Salsitz said. “But they certainly shouldn't be first-line and they should be used very cautiously.”
Although information on the risk of addiction from opioids and the changes to prescribing recommendations are recent, Salsitz said practitioners should be able to adapt.
“Things in medicine change; they're neither hard nor simple,” he said. “But if you're going to be a responsible, reasonable provider of health care, you have to keep up with new information and in terms of opioid prescribing. The easiest way is to review the CDC guidelines and follow them."