Reflecting the concern about the opioids issue and the difficulties physicians encounter wrestling with it, about 140 doctors and others came out May 1 to hear a panel of MSSC members share their expertise at “Opioids: A Closer Look.”
During the program at Distillery
244 in Old Town, MSSC President Dr. Jed Delmore moderated a panel discussion by Drs. Greg Lakin, an addiction specialist and the state’s chief medical officer; Dr. Joe Davison, who has served on the K-TRACS advisory board since its inception; and Dr. Daniel Warren, a faculty member at KUSM-Wichita specializing in substance abuse.
Dr. Delmore shared how pain medications are a fact of life in his gynecological oncology practice and gave an overview of the opioid crisis in Kansas and nationally. He shared statistics on deaths, addiction and how addicts obtain drugs, with the intent of establishing “where we fit into the big picture.”
Dr. Lakin elaborated on where Kansas stood nationally, noting “Kansas has avoided the crisis to a certain extent. Our overdose deaths have actually gone down.” Still, he said, drug poisonings are the leading cause of unintentional death. Addiction, he said, is “not just a poor man’s disease.” Overdose deaths come among people in their 30s, 40s and 50s, ones holding jobs and functioning to some extent. “It’s not just the young, careless and wild.”
The state and other entities, such as a joint KMS-KHA task force, are pursuing strategies to contend with the issue, and Dr. Lakin said physician involvement in the matter was essential.
Dr. Davison explained how the K-TRACS monitoring program came about, noting a local “pill factory” heightened awareness and “this community of physicians said something had to be done.”
K-TRACS has been increasingly effective in finding “threshold patients” who visit multiple doctors and pharmacies. Now, K-TRACS is planning to provide physicians with a scorecard of dosages, frequency and other factors. It’s a work in progress but worthwhile, he said. “We do not look into your offices and your charts,” he said.
When abuse concerns arise, Dr. Davison urged colleagues to help patients find treatment or otherwise work to manage the situation. “Don’t just dispose of that patient,” he said.
Dr. Warren expounded on that point. By the time a patient arrives in treatment, they have often lost nearly all their healthy connections – job, family, friends – so the specialist’s focus is to help them
reconnect. “Our patients come expecting to have a road forward offered,” he said. A lack of treatment options is a challenge, he said, with many Kansas counties lacking programs and methadone programs available only in just Wichita and a few other cities.
The evening concluded with audience questions. Queries included whether midlevels should prescribe narcotics (depends on practice focus, Dr. Davison said); whether fentanyl deaths were specifically tracked (working to improve, Dr. Lakin said) and whether chronic pain was real and if opioids were necessary to treat it. The chronic pain issue brought forth a range of opinions on that point, with panelists largely agreeing that in many cases it was valid.
Dr. Lakin urged physicians to stay involved in policy matters. Lawmakers “want to do something,” and if doctors do not lead, there’s the chance the void could be “filled with things we don’t like.”