VIEWPOINTS
Thursday, December 23, 2021
JEFF MERKLEY
East Oregonian
A5
DAVID RUSSO
OTHER VIEWS
Help solve
the opioid
crisis with
alternatives
T
he terrible pain caused by the opioid
crisis has reached every commu-
nity in our country. So many of us
have heard from Oregonians whose loved
one died from an opioid overdose after
struggling with addiction — all because
they fi lled an opioid prescription. And
our nation’s overdose death rate soared to
record highs during the coronavirus public
health emergency.
Preliminary data from the Centers for
Disease Control and Prevention released
in August show that drug overdose deaths
in 2020 rose nearly 30%, to a record-set-
ting 93,331. Opioids, including prescrip-
tion pain medication, caused a staggering
three-quarters of those deaths — a record
69,710 lives lost. Sadly, Oregon has been
hit hard with a nearly 44% increase in
overdose deaths over the past two years.
Putting a stop to this opioid crisis
requires a multifaceted response with
economic and social dimensions. It also
requires us to look at the underlying policy
and commercial factors that drove the
epidemic to reach such staggering heights
of tragedy and despair.
Health care providers have taken
steps to try to reduce the contribution of
prescription drugs to the opioid epidemic.
According to the American Medical
Association, physicians and other health
care professionals’ use of state Prescrip-
tion Drug Monitoring Programs increased
64.4% and opioid prescriptions decreased
by 37.1% from 2014 to 2019. Yet, opioid
overdoses continue to be a problem,
largely driven by illicit forms of opioids.
Health care providers need access to a
variety of options to manage their patients’
pain, but often administrative and fi nan-
cial barriers get in the way of compre-
hensive, multidisciplinary pain care and
rehabilitation programs.
In order to increase access to safe and
eff ective non-opioids across America’s
health care landscape, we are pushing for
passage of the bipartisan Non-Opioids
Prevent Addiction in the Nation Act. This
legislation would address the barriers
within Medicare reimbursement policies
that lead providers to prescribe opioids.
By fi xing the policy, providers could more
easily off er non-opioid pain management
alternatives to Medicare patients undergo-
ing surgery.
Under the current system, Medicare
does not allow adequate reimbursement
for alternatives to opioids. Instead, the
program shoehorns almost all non-opioid
pain management treatments — drugs,
devices, and biologics — used in outpa-
tient surgery into payment “packages”
that don’t allow for separate reimburse-
ment for individual treatments. As a result,
providers can either take a fi nancial hit to
prescribe the alternative pain management
treatments or be fully reimbursed when
they prescribe opioids — even if alterna-
tives would be more appropriate for the
patient.
That’s why it is critical to pass the
NOPAIN Act. By directing Medicare to
allocate separate reimbursement for pain
management alternatives approved by
the Food and Drug Administration, we
can ensure patients undergoing a surgical
procedure have a choice when deciding
which treatment is best for them.
Importantly, this legislation would
not prohibit or stifl e patient access to
physician-prescribed opioids for chronic
or acute pain in any way. Instead, the
NOPAIN Act would create an equal
playing fi eld that gives doctors and their
patients more autonomy when choosing
between diff ering opioid or non-opioid
treatments.
With so much pain and hardship
wrought by the opioid epidemic, Congress
must spearhead innovative policy reme-
dies that help address the structural causes
of the crisis. The NOPAIN Act is one such
remedy. By fi xing Medicare’s reimburse-
ment policy to ensure patients across the
country have a choice between diff ering
pain management treatments, we can help
combat one of the major drivers of this
addiction epidemic.
———
U.S. Sen. Jeff Merkley is a cosponsor of
the NOPAIN Act. Dr. David Russo is a phys-
iatrist and pain management specialist at
Columbia Pain Management, PC, in Hood
River and a member of the Oregon Medical
Association.
The world record high jump
ANDREW
CLARK
A SLICE OF LIFE
A
spitting cobra is a beautiful animal,
sleek and shiny black, and if fi lleted
and lightly fried in butter quite deli-
cious too — a light and pleasant taste.
By contrast, eating a python cooked the
same way, which I had only one opportu-
nity to try, was what I would envision as
eating a piece of truck tire. You chew and
chew and chew until your jaw muscles are
fatigued and there is no discernible diff er-
ence in the texture. Butchering a cobra, or
any snake, is interesting too.
The paired organs — lungs and kidneys
and testicles — are not bilaterally symmet-
rical as in mammals but rather they are
in-line, one in front of the other, and other
organs are also streamlined length-wise.
I do not like to kill animals, including
cobras, but one place where we lived in
Tanzania had occasional spitting cobras
come into the yard and, with our fi ve young
children running around playing, the risk
was too great. One might accidentally
bump into a cobra.
I did kill several with a simi knife, a slim
half-size machete, and it is quite a duet of
movement sparring with the cobra only a
few feet away. I was happy to wear glasses
because their aim is for the eyes, and I had
venom on my glasses several times. The
venom is extremely painful, very disabling
and permanently damaging. My Maasai
veterinary staff taught me how to judge
how far a cobra can strike, which is the
length of how high the cobra is standing up,
and that turned out to be handy knowledge
while doing the cobra-killer dance with a
too-short knife.
The event I remember best was with
a very large male of more than 7 feet in
length who came for a visit in our back
yard. He and I had a very active fi ght, weav-
ing and dodging. I wounded him multiple
times. He tried to escape by running under
our truck, so I ran around the truck intend-
ing to block him and fi nish him off . Cobras
can move very fast, he did not even slow
down and we were on collision course.
There is an ‘ wives tale about how some
snakes can lunge straight up when they feel
the need, even more than their length. So
what about old wives and their tales? Does
that make any sense? Surely not. But wait
a minute. A lot of wisdom originates from
experience, correct? And what if those old
wives are right?
My instantaneous calculation was that if
he was 7 feet long and could lunge at least
his length and maybe a half-length more,
his mouth would be at about 10 or 11 feet.
For the sake of safety and according to the
old wives, I would need to clear 12 feet at
least.
So I did. I made a soaring leap over that
cobra, returned to the fi ght and fi nished
him off , dissected and fi lleted him, and we
enjoyed an excellent appetizer as mentioned
above.
However, the problem of making a
world record high jump where the ground
is packed and hard is not making the actual
jump — that’s the easy part. It’s coming
down that is the problem. If you’ve ever
fallen off your roof or out of a tree you will
know what I mean and empathize.
Several months ago I mentioned that
I had established four world records in
track and fi eld events. This is the third.
The others were hippopotamus and buff alo
and now this cobra. It’s been fun, but I
can’t write about the fourth one because it
involves a tryst atop a huge granite rock,
pheromones, inquisitive lions away from
whom I set the 50-meter dash record, and
a very, very close encounter in which we
nearly became recycled biomass out on the
Serengeti.
Two postscripts. First, if you would
like to know more about the Serengeti, an
ecosystem unique in the world, the Decem-
ber National Geographic has a wonderful
article between pages 34 and 133. Second,
if you would like to see a spitting cobra spit,
just Google “spitting cobra” and you will
see it and many other species of this hand-
some genus of animals.
———
Dr. Andrew Clark is a livestock veteri-
narian with both domestic and international
work experience who lives in Pendleton.
The tradition of change
J. MARK
BROWNING
OTHER VIEWS
T
radition: The way we pass customs
or beliefs to each other, from one
generation to the next, to secure the
continued practice or shared value persists.
Tradition, or common practice, tells
us this time of the season we are to look
forward to the next year, to set our goals,
resolutions and affi rm all that it will take to
improve upon our fortunes and futures.
Here at Blue Mountain Community
College, we have a rich tradition of serv-
ing our students and communities through
educational opportunities that result in
brighter futures. May this tradition always
persist! However, adjustments are needed.
The tradition of our commitment to serve
is and must remain constant. How we apply
that commitment to action is however in
need of change.
Our world is changing daily around us.
The education consumer has spoken. Loud
and clear. We must be more adaptable and
innovative in our approaches, our delivery
methods and our expected outcomes and
more.
The emerging industries, along with
very strong futures in many traditional
fronts, suggest a myriad of opportunities
for our students and for BMCC. We need
to adjust. A number of community colleges
across our country are heading into these
new approaches with vigor and equally
encouraging results. We as consumers vote
through our choices as to how we spend our
money. Education customers should expect
the same. You learn of new opportunities
in a quickly growing fi eld such as data and
cyber security. Why should you have to
wait until the next start of an academic year
to begin? Why should you have to wait even
until the next quarter or semester? Short-
er-term courses, more focused training
with an eye to outcomes are critical to our
future success. A new Blue, if you will,
moving forward.
These types of shifts in delivery
approach will require all of us to adapt
and change. Funding partners such as the
Oregon Legislature and the Higher Educa-
tion Coordinating Commission will need
to rethink how they support not just BMCC
but all of the 17 community colleges. The
role each of those 17 plays in our various
regions and communities is unique and
acutely needed to ensure the long-term
sustainability of our economies and citi-
zens. Here at BMCC this is going to require
all of us, primarily faculty, staff and admin-
istration, to think, plan and act diff erently.
To think, plan and act proactively, to truly
be “students fi rst” and put their interests
and outcomes foremost in our eff orts. This
is a tradition which we have held to strongly
here at BMCC over the years previous. New
markets, new industries, new methods and
consumer trends really are mandating that
we change our approaches for everyone
involved: our students, our business and
industry partners and the region.
This work will begin as we start to
formulate our long-term outlook, budget-
ary supports and operational plans in early
2022. It’s never easy changing or adapting
a tradition, to be sure. But the outcomes
that await students who are readily employ-
able — who have the skills and abilities to
succeed in their endeavors — make any
eff ort worthy of our time and commitment.
Lastly, both Kym and I would like to
thank the BMCC community, the Pendle-
ton and area communities who have been
so welcoming of us as we’ve started our
next chapter of our lives here. You have
been warm in reaching out, so very helpful
in getting settled — it truly is feeling like
home for us!
May each of you enjoy the season and
have a wonderful new year ahead. Go
Timberwolves.
———
J. Mark Browning is the president of Blue
Mountain Community College.