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LOCAL A14 • HERMISTONHERALD.COM WEDNESDAY, AUGUST 28, 2019 Pharmacists, doctors, say fewer opioids prescribed in recent years iatrist for the clinic, said the newer generation of doctors is more wary of prescribing opioids. “Many primary doctors are looking for a specialist that can help get their patients off opioids, so interventionists like pain physi- cians and physiatrists are in higher demand to provide more alterna- tive pain control options,” she said in an email. “Further, the under- standing of the psychological com- ponent to pain and our reaction to it has garnered interest and the need for pain psychology.” She said studies have suggested that opioids, while effective in the short term, are no more effective than Tylenol in treating chronic pain. It’s important medical pro- viders address root causes of pain, she said, and manage expectations so that patients understand that in some cases it is not possible to live completely pain-free. By JADE MCDOWELL NEWS EDITOR In the year 2006, the world was mourning the death of Croc- odile Hunter Steve Irwin, arguing about Al Gore’s “An Inconvenient Truth” and buying their fi rst Blu- ray discs. In the medical industry, doc- tors were being told that too many patients were in pain after being denied their “right” to prescription painkillers known as opioids. “In 2006 there was a lot more focus on pain control,” pharma- cist Ann Murray said, calling it a “push” in the early 2000s. Murray, who runs Murray’s Drug in Heppner, Boardman and Condon with her husband, John Murray, said there wasn’t the same level of awareness around opioid addiction back then. Opioid overdose deaths in Ore- gon peaked that year, at 238. After waging a yearlong legal battle, the Washington Post recently obtained data from the Drug Enforcement Administration tracking the path of every prescrip- tion pain pill in the United States between 2006 and 2012. It shows millions of opioids were fl owing into Eastern Oregon each year. From 2006 to 2012 Oregon received more than 1.3 billion prescription pain pills, according to the Post’s database. Of those, 22,583,610 were supplied to Uma- tilla County pharmacies — enough for every person in the county to receive 43 pills per year. Mor- row County pharmacies received 1,235,200 pills, enough for 15 pills per person per year. Those num- bers don’t include prescriptions patients received directly via mail order. John Murray said the database has its limits — their Condon phar- macy, for example, shows a high “pills per person” count for Gil- liam County because it doesn’t take into account that they also serve neighboring counties, such as Wheeler and Sherman, which don’t have any pharmacies. “I applaud looking at these numbers, though, because you have to start somewhere,” he said. Since the Post’s database came out, some pharmacists have shifted blame for opioid overuse on doc- tors, saying they didn’t feel they could say no to fi lling prescrip- tions. But legally, pharmacists do have a right to step in when they have suspicions of abuse or other worries. The Murrays say they often do just that. They cross-reference the patient’s prescription history through the Prescription Drug Monitoring Program and will call up a physician to ask if they were aware the patient is already receiv- ing drugs from another provider, are a fi rst-time opioid patient or Changing laws Staff photo by Ben Lonergan Ann and John Murray pose in front of the Heppner location of Murray’s Drug Friday afternoon. on other medicines, such as mus- cle relaxants that make opioid use more dangerous. The calls some- times result in an agreement that the dosage should be adjusted. They even worked with police when someone at an area clinic was illegally calling in prescrip- tions not authorized by the doctor. “We’re the last line of defense people have (against misuse),” John said. “We have a co-respon- sibility with providers.” Patients are also more likely to self-police their use these days after reading about the dangers or seeing someone close to them bat- tle addiction. “People will say, ‘This was written for 30 days but please just give me 10,’” Ann said. Preventing abuse On the other end of the spec- trum are people still trying to game the system. Steven Hardin, emer- gency department manager for St. Anthony Hospital in Pendleton, said ER doctors are no strangers to people making up stories about having injured themselves while traveling or getting their medica- tion stolen. St. Anthony doesn’t replace prescriptions patients claim were lost, stolen or “eaten by the dog,” Hardin said. And when someone comes in looking for a new pre- scription for an injury, the depart- ment can use the Emergency Department Information Exchange to check their story. “We’ll ask if they tried anyone else and they’ll say no, but EDIE will tell us Joe already hit up two other emergency rooms in the last 30 days,” Hardin said. The emergency room hands out signifi cantly fewer opioids than it used to. In the past, someone with an injury that would be expected to heal in a few days might have auto- matically been given a 30-day sup- ply. Now, they will get two or three days’ worth. ER departments have shifted from “just believing patients,” Hardin said, to checking history, alerting primary care providers of ER visits and comparing the pain level patients claim with what X-rays and other tests are actually showing. “We say no a lot, which isn’t popular,” he said. Safe use of opioids On the other hand, Hardin said, they don’t want to scare off people who legitimately need something stronger than ibuprofen. Opioids can help someone function in the early stages of healing from sur- gery or serious injury, which can be healthier than lying down all day just thinking about their pain. The Centers for Disease Con- trol provides guidelines for taking pain medications safely, encourag- ing people to never take more than prescribed or for longer than pre- scribed, and to step down their use as their pain decreases. Jaine Crowell, community health educator for Good Shepherd Health Care System in Hermis- ton, said mixing opioids with other medications or alcohol is one of the main causes of overdoses. The hospital is starting to hold trainings for the public on how to adminis- ter Nalaxone, which reverses the effects of an overdose. Those who have prescrip- tion medications in the house are encouraged to lock up the drugs they’re actively using and safely dispose of anything extra, cutting off opportunity for theft by friends or family secretly battling addic- tion. Area police departments have secure drug take-back boxes, and Good Shepherd recently added one to their pharmacy for people who don’t feel comfortable drop- ping off unused pills at the police station. Crowell said they are also working with other partners in the area on a campaign to reduce the stigma of admitting an addiction to opioids — something she said can affect people of any demographic. Juli Gregory, education director for Good Shepherd, said there are a lot of resources for people who fi nd themselves addicted to pain- killers, from peer support groups to counseling. One frustration, how- ever, is that Medicare does not pay for inpatient rehabilitation treat- ment for addiction. “It’s not just people who rec- reationally use drugs,” she said. “Seniors have a high rate of addiction.” Alternatives to opioids As awareness has increased about the addictive nature of opi- oids, medical providers are upping their focus on controlling pain without medication. Good Shepherd offers regular classes on “living well with chronic pain.” It also recently opened a Physical Medicine and Rehabili- tation clinic, offering comprehen- sive pain management strategies ranging from chiropractor sessions to peripheral joint injections. They plan to add an acupuncturist and massage therapist to the staff soon. Dr. Miriam Washington, a phys- As the country has been gripped by a crisis of addiction and over- doses, lawmakers on the state and federal level have passed new laws addressing the epidemic. Some of those have resulted in the prescrip- tion and emergency room monitor- ing databases listed above, while others have increased penalties for improper prescribing or increased money for treatment. In October, President Donald Trump signed the SUPPORT for Patients and Communities Act, a package of laws which Rep. Greg Walden told the East Orego- nian is “the most signifi cant effort ever made to combat a single drug crisis.” Among its provisions were reauthorization to continue provid- ing $500 million a year for the opi- oid crisis, increased measures to stop fentanyl from illegally enter- ing the country, removing some restrictions on medication that treats opioid addiction and increas- ing access to Nalaxone for fi rst responders. In the past few years, Walden has held roundtables in Pendle- ton, Hermiston and other parts of Oregon about opioids, taking feed- back from medical providers, law enforcement, mental health agen- cies and people in recovery from addiction. He said in an emailed statement that as chairman of the Energy and Commerce Commit- tee he also conducted hearings that resulted in a 325-page report “that uncovered numerous warn- ing signs and red fl ags missed by wholesale drug distributors and the Drug Enforcement Administration (DEA) that contributed to the opi- oid epidemic.” He added, “We’ve made prog- ress, but there is much left to do and I plan to continue to hold roundtables, propose legislation, and monitor this epidemic until we can solve it once and for all.” Blue Mountain Community College kicks off soon By JESSICA POLLARD STAFF WRITER With a month to go before the start of the term, Blue Mountain Community College is seeing an uptick in enrollment. Casey White-Zollman, vice president of public affairs at BMCC, said that as of this week, full-time equivalent enrollment is up by 5%. She said the college wel- comes the increase, which is markedly unusual. “Oftentimes when the economy is very good, com- munity college enrollment tends to be on the decline. When the economy has a downturn, that’s when we tend to see our enrollment increase,” White-Zollman Staff photo by Ben Lonergan Blue Mountain Community College sits nestled in the hills above Pendleton. The college is preparing to welcome students back for fall term in the coming weeks. said. White-Zollman noted that enrollment tends to ebb and fl ow on a weekly basis, and that these numbers could change. “To have a bit of an anomaly is a great thing for us right now,” she said. BMCC Hermiston Center Director Jacelyn Keys said the Hermiston Center is see- ing high enrollment across the board, including in lan- guage acquisition and GED classes. “We’re a part of that (increase). I think that comes from having the larg- est school district in Eastern Oregon in our backyard,” she said. And while fall term, which starts Sept. 23, will surely reveal new student faces on campus, it will also represent the start of incom- ing president Dennis Bai- ley-Fougnier’s fi rst full year on the job. Bailey-Fougnier was hired in March, and previ- ously served as the vice pres- ident of community college affairs at Colorado Mesa University in Grand Junc- tion, Colorado, and as chief executive at Western Colo- rado Community College. He got his bachelor’s degree at the University of Oregon and later earned a doctorate degree in commu- nity college leadership at Oregon State University. Earlier in the summer, BMCC secured $13 million in legislative funding for the FARM II Project, a facility that would provide room for agriculture and veterinary training. White-Zollman said that as of this summer, the grounds — situated on land owned by the Pendleton Round-Up — are cleared and will be used as a parking lot during the rodeo event. In winter, the school will begin the request for proposal pro- cess to fi nd an architect for the FARM II building. While incoming students won’t see much of a change in available classes this year, the college is looking into offering unmanned aerial systems classes in the future, White-Zollman said. “We’re always working to try to meet the needs of the community,” she said. Keys said that the Herm- iston Center is working to develop new continuing edu- cation courses, which will debut next school year. Registration for classes at BMCC runs through Sept. 27. Incoming students are invited to the BMCC event Welcome to the Pack on Sept. 18, 8 a.m. to 2 p.m. on the Pendleton campus, for an opportunity to meet fac- ulty and learn about campus resources.