Opioid Awareness

SEPTEMBER 2019 | FUTUREOFPERSONALHEALTH.COM

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OPIOID AWARENESS Chris Herren

Find out how this NBA star is using his own experience to help other addicts recover

Learn some helpful ways to talk to a loved one struggling with addiction Discover the truth behind common addiction treatment misconceptions

HOW CAN I BE ADDICTED? I GET THESE FROM MY DOCTOR. –BRENDA

Prescription opioids can be addictive and dangerous.

It only takes a little to lose a lot. cdc.gov/RxAwareness

FIND SUPPORT As we form a deeper understanding of opioid abuse, so too do we develop resources to help those struggling with addiction.

To help yourself or someone you know: CALL SAMHSA’s National Helpline 1-800-662-HELP (4357) TTY: 1-800-487-4889 Parent Helpline 1-855-DRUGFREE VISIT Partnership for Drug Free Kids www.drugfree.org SAMHSA’s Prescription Drug Misuse and Abuse Website www.samhsa.gov/ prescription-drugmisuse-abuse SAMHSA’s Behavioral Health Treatment Services Locator www.samhsa.gov/ find-help American Society of Addiction Medicine www.asam.org

Addressing Opioids in the Workplace The National Safety Council has made new resources available to employers looking to address the opioid crisis with their employees.

Rachael Cooper Senior Program Manager for Substance Use Harm Prevention, National Safety Council

ccording to our survey, 75 percent of U.S. employers have been directly affected by opioids, yet only 17 percent feel extremely well prepared to deal with the matter.

In fact, 38 percent of those surveyed said they have experienced absenteeism or impaired worker performance because of employee opioid use, while 31 percent have had an overdose, arrest, or near-miss.

An outline for employers In an effort to assist employers who want to address opioids in the workplace, the Council has made available its new Opioids at Work Employer Toolkit.

The free toolkit has a focus on safety and includes information and resources for

four specific groups found in a typical workplace setting: supervisors, HR professionals, safety professionals, and employees. It also includes a section composed of introductory, level-setting materials on the opioid crisis, prevention, treatment, and recovery.

Starting the conversation For example, the “Opioids and the Workplace” document included in the toolkit is helpful for those who have just been introduced to the topic. It provides background information about the opioid crisis, as well as details about prescription opioids, heroin, fentanyl, chronic pain, acute pain, treatment, and recovery. It also defines relevant terms, outlines how the issue impacts employers on both the business side and safety side, and details key steps employers can take to address the issue.

Other materials in the toolkit include a sample policy for HR professionals to use when updating or creating a drug-free workplace policy: a document on impairment, safety, and opioids for safety professionals; a paper on communicating with employees about opi-

oids for supervisors; and a video about how drugs affect the brain as an educational tool for employees.

Just the beginning The toolkit has more than two dozen resources, all of which can be found at nsc. org/opioidsatwork.

It is a great complement to existing Council resources, such as its Substance Use Cost Calculator for Employers, which can be used to assess the financial impact of this issue on an individual workplace.

More than 75 percent of people living with a substance use disorder are in the workforce, and more than 10 percent of Americans live in recovery. Research indicates that individuals struggling with substance use disorders have better sustained recovery rates if treatment is initiated and monitored by their employer than if that treatment is initiated by friends or family.

Take the time to explore our toolkit today. Employers can help protect their bottom line, the safety of their workplace, and help save lives when they use NSC’s Opioids at Work Employer Toolkit. n

Publisher Shira Peretz Business Developer Gretchen Pancak Managing Director Luciana Olson Lead Designer Tiffany Pryor Designer Keziah Makoundou Lead Editor Mina Fanous Copy Editor Travis Atwell Director of Sales Shannon Ruggiero Director of Business Development Jourdan Snyder Director of Product Faye Godfrey Content Strategist Vanessa Rodriguez Cover Photo Rob Van Petten All photos are credited to Getty Images unless otherwise specified. This section was created by Mediaplanet and did not involve USA Today.

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Drug Deactivation: A Solution to the Opioid Epidemic Prevention is more than just dispensing less, it’s about removing the abundant supply of prescription opioids from circulation to prevent abuse and misuse.

When it comes to opioids and other powerful — and dangerous — medications, the problems facing the country are well-known:

Dangers In your medicine cabinet The root of many of these problems is right in your homes. More than 60 percent of people with leftover prescription opioids keep the pills for future use rather than disposing of them, with 1 in 5 reporting they shared their medication with another person (known as “diversion”). We all know this leads to misuse and addiction.

Even when leftover drugs are disposed of, they are often flushed down sinks and toilets or improperly disposed of in the household trash, where these still potent drugs can harm our environment. Additionally, wastewater treatment plants are generally not designed nor equipped to remove pharmaceuticals which means that these drugs make their way into our lakes, rivers, streams, and soil.

A solution proven to increase disposal habits Studies have shown that using an at-home disposal system such as the Deterra® Drug Deactivation System helps stop opioid and other medication misuse before it starts.

Deterra is an immediate alternative to flushing or discarding medication and prevents still-potent drugs from contaminating our water supply and landfills. Deterra has a positive impact on the removal of dangerous medicines from the home while protecting the environment: • A study published in JAMA Surgery conducted on post-operative adult surgery patients found that those given Deterra for at-home disposal were nearly four times more likely to safely dispose of their leftover and unneeded medications. The authors concluded, “Our findings

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suggest that simple, low-cost interventions, such as in-home deactivation methods, could reduce the number of unused opioids available for diversion.”

• Another study published in JAMA Pediatrics focused on 202 pediatric surgery patients found that when families were provided Deterra Drug Deactivation Pouches, it increased overall disposal habits while decreasing the amount of medicines disposed in the sink or toilet, keeping these drugs out of the environment.

Real-world use The real-world experience matches the studies’ findings: “Our farm and rural families have a tendency to hang on to unused medicine, in case they may need it in the future,” notes Ruth Linkenmeyer-Meirick of the Minnesota Farm Bureau. “Educating them

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Tear open pouch - do not open or remove inner pod(s). Place unused medications inside.

Fill pouch halfway with warm water and wait 30 seconds for air to release.

Some foaming may occur.

on the importance of proper prescription medicine disposal and providing the Deterra Drug Deactivation and Disposal system has helped prevent opioid misuse and abuse, as well as offering them an environmentally sound way to properly dispose [of prescription medicine], which is very important to our population.”

“Providing the Deterra Drug Deactivation and Disposal System to our patients with post-surgical opioid prescriptions has decreased the number of pills available in homes for misuse,” says Rachel Uzlik of Twin Cities Orthopedics in Minnesota. “As well as keeping them out of the waste stream.”

Dispose of dangerous le�tover medication in minutes With Deterra, you can rid your home of unused, expired and unwanted opioids with three easy steps:

3 Seal pouch tightly, gently shake and dispose of in normal trash.

Each of us has a responsibility to destroy and dispose of unused and unwanted prescription and over-the-counter drugs that are so often subject to dangerous misuse and abuse. Clean out your medicine cabinet during National Recovery Month to keep dangerous drugs away from the ones you love.

Learn more at DeterraSystem.com [i] https://www.cdc.gov/drugoverdose/maps/rxrate-maps.html [ii] Effect of Activated Charcoal Bag on Disposal of Unused Opioids After an outpatient Surgical Procedure: A Randomized Clinical Trial. JAMA Surg. Published online March 27, 2019. Doi: 10.1001/jamasurg.2019.0155 [iii] https://wonder.cdc.gov/

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Flipping the Standard for Low Back Pain Management

According to a 2010 study in the journal Addiction, as many as 1 in 4 people who receive a prescription opioid for non-cancer pain in primary care settings struggle with addiction. By exposing patients to non-drug treatments first, the hope is that some will find enough relief to reduce or even avoid their exposure to prescription pain medications.

A promising future Evidence supports that hope.

A 2018 study published in the Journal of Alternative and Complementary Medicine found that patients who received services from a chiropractor for back pain — one of the most common conditions for which opioids are prescribed — were 55 percent less likely to fill a prescription for an opioid medication than other patients.

Expanding access Efforts to increase seniors’ access to pain management alternatives have gained steam. A bill introduced this summer, H.R. 3654 (www.hr3654.org), would give Medicare beneficiaries access to more non-drug options for pain management available in their chiropractors’ clinics.

For more information about chiropractic, visit www.acatoday. org/patients.

American Chiropractic Association

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PHOTO: HERREN TALKS

The idea that pain should be addressed �ırst, where possible, with non-drug therapies such as spinal manipulation, physical therapy, massage, or acupuncture has gained support among major healthcare organizations in the wake of the opioid epidemic.

How the NBA’s Chris Herren Is Leading the Charge for Substance Recovery

A�ter his own battle with heroin addiction, former NBA star Chris Herren is now helping thousands of kids with their own recoveries.

In 2009, Chris Herren celebrated his first year of sobriety. Two years later he founded the Herren Project, a nonprofit organization that offers support for people suffering from substance abuse.

“I’m just grateful that over the last 11 years I’ve been part of it, and I’ve been able to share it with others,” he said. “That’s the profound part of this. I’ve been blessed with the opportunity to give hope.”

Journey to recovery When Herren’s own path to sobriety began in 2008, his family and friends were his support network.

“I wanted to be the father my kids deserved,” he said. “I wanted to be the husband that my wife married and the son that [my] parents could be proud of.”

Support from his family inspired Herren to use his platform to give back to others via the Herren Project.

“I was not only able to see but to feel what recovery did for me and my family,” Herren said. “Addiction breaks the hearts of every-

body that loves you. I wanted to be part of the healing process.”

A way forward Through the Herren Project, Herren has spoken to millions of school kids and parents about coping with substance abuse. He encourages parents to actively communicate with their children about drinking and drugs.

Raising awareness Herren is currently promoting his new documentary, “The First Day,” streaming online.

“When it comes to addiction, especially with our children, we oftentimes remind them of the worst day, and we forget about the first day,” he explained. “We talk about how it ends rather than why it became.”

For Herren, recovering from substance abuse is a lifelong journey. “There is no finish line in recovery. You don’t break the tape and run through it,” he said.

Through his work with the Herren Project, which has helped thousands of students, Herren has found hope in himself.

“Sobriety gives us a gift,” he said, “and that gift is that we are ourselves 24/7. For me, that’s an edge in life.” n Ross Elliott

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According to the Centers for Disease Control and Prevention, approximately 50 million U.S. adults live with chronic pain (pain lasting at least 6 months). Drug therapy has come under scrutiny as a result of the opioid epidemic.

Agencies including the National Institute on Drug Abuse and the Pain Management Best Practices Task Force are focusing on advancing best practices for pain management. Drug-free spinal cord stimulation (SCS) is emerging as the future of pain therapy in many patients.

“There is a tremendous need for effective drug-free pain management options, and we are very excited about the role of spinal cord stimulation in providing relief for many patients who suffer from chronic pain,” says Rafael Carbunaru, Ph.D., vice president of neuromodulation research and

development at Boston Scientific.

Pain is felt when nerves send signals through the spinal cord to the brain. Spinal cord stimulators interrupt these signals with mild electrical pulses. This drug-free, FDA-approved pain management therapy has been around for 50 years, and recent advances give more options to meet each patient’s unique needs.

“We believe in providing capable and flexible systems that allow physicians to personalize the therapy for each patient — today and in the future,” says Carbunaru. “Our newest device, the Spectra WaveWriter™ SCS system provides multiple therapy options, which gives physicians a better chance of finding the optimal form of pain relief for individual patients.”

Moreover, “the patient can trial this therapy for a few days to determine if it works for them, before proceeding as a long-term therapy,” he says. Over 90 percent of patients who use Boston Scientific products report a successful trial experience.

Patient-centered approach Since pain management can be complex and varies from person to person, it’s important for

PHOTO: MATT LOCKE

The FDAApproved Therapy That’s Helping Patients Manage Chronic Pain Without Opioids patients to work with their doctor to personalize a plan.

“There is no one-size-fits-all approach when treating and managing patients with painful conditions. Spinal cord stimulation is definitely one of the major treatment modalities and has made great strides recently,” says Dr. Vanila Singh, M.D., chair of the Pain Management Best Practices Inter-Agency Task Force, a federal advisory committee established by the Comprehensive Addiction and Recovery Act of 2016.

She encourages patients to keep a journal of symptoms, goals, and treatment progress: “You are your most important advocate.”

Boston Scientific just announced mySCS™, an app to maximize a patient’s chance for successful SCS trial and progression to the implant and therapy.

It allows for real-time support, simple progress tracking during the SCS trial, and provides a report that patients can share with their physicians.

Life with SCS Mike Webb, 62, got a spinal cord stimulator to help manage his chronic back pain. The Austin, Texas drummer fell nearly a

decade ago and injured two vertebrae. His doctor had prescribed Tramadol, an opioid, which Webb took up to three times a day.

After his doctor recommended he try this alternative therapy, Webb received a trial stimulator.

He said he immediately felt relief.

“It was just outstanding,” he says. “I was totally off of pain medicines. I was out and about the next day. It was wonderful.”

A few months later, Webb, a grandfather and great-grandfather, had the surgical SCS implant. He can adjust the setting for his back pain with a controller and he no longer takes any pain pills. He says one of his treatment options feels like a massage.

While the experience for each patient is different, “this has been kind of a miracle for me,” he says.

“It makes the back pain, the nerve pain, manageable.”

For more information, visit www.ControlYourPain.com/ usatoday Safety information for the Spectra WaveWriter SCS System™ is available at www.controlyourpain.com/safety-information. Ask your doctor if SCS is right for you. n Kristen Castillo MEDIAPLANET • 5

How to Approach A Friend Who Needs Addiction Treatment Watching a friend struggle with an addiction and encouraging professional treatment, such as rehab, can feel like an absolutely insurmountable and terrifying task.

This fear may drive you away.

You may even think that you have no right to interfere in their personal problem.

You have a right to speak up and let your friend know that you are concerned about them and that they may be a danger to themselves and/or others, as well as the right to strongly encourage that they get professional treatment for their addiction and pursue help for their illness.

Understand what addiction is and how it feels

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The first thing you will want to do is educate yourself on addiction.

In order to approach an addict or alcoholic in a way in which they will be most receptive, you’ll have to try to do as much research as you can in order to step into their shoes and get into their minds as much as humanly possible.

demeanor. Withdrawal symptoms include unsteady hands, poor balance, nausea, and an array of other unpleasant symptoms.

Do your research so you can understand the signs and be able to clearly understand why it is you’re deciding to have a conversation with your friend.

Understand what addiction looks like Some social symptoms of addiction may include becoming increasingly withdrawn, missing school or work, legal issues, or relationship and marital turbulence. Physical symptoms can range from weight loss, strange or sped-up speech, looking malnourished, and an overall “unwell” appearance or

Do your research on the types of treatment Rehab centers, detoxification centers, one-on-one cognitive or dialectical behavioral therapy, medication, and outpatient treatment are some of the many options for addicts who need to overcome their disease.

Speak to them when they are sober

Here, the ideal outcome is addiction treatment or rehab.

Catch your friend when they are sober and ask if you can sit with them and talk to them for a bit. No pressure. Insist it is important to you.

Come from a place of love You are speaking to your friend about their addiction because you love them. Make this clear.

Addiction affects everyone around the addict. No matter what you think, you have a right to speak up and let a friend or loved one know that it’s hurting you to watch them hurt themselves. You may be one of the reasons a friend chooses to save themselves, and that’s worth a conversation. n Mark Shandrow, CEO, Asana Recovery

Avoiding Common Addiction Treatment Myths Rehab in Malibu? Twelve-step programs?

Behavioral therapy? Medications?

Inpatient vs. outpatient? What should addiction treatment look like? What comes next for people in recovery a�ter initial phases of treatment?

As the country’s overdose epidemic continues to make daily headlines, more and more Americans are wondering what treatments really save lives. While the addiction treatment landscape is overwhelming and difficult to navigate, there is hope. Decades of research show that addiction is a disease that can be treated and managed with the same effectiveness as other chronic illnesses such as hypertension and diabetes.

To cut through the misinformation, Shatterproof put together the Shatterproof

National Principles of Care for Substance Use Disorder Treatment©. These principles are the core concepts of quality addiction treatment that are shown to improve patient outcomes when treating substance use disorders. Derived from the “Surgeon General’s Report on Alcohol, Drugs, and Health,” the best practices outlined in the principles are backed by rigorous research. Addiction care that aligns with these principles will help people find lasting recovery and prevent future tragedy: • Screening for substance use disorders in all medical care settings • Diagnosis, assessment, and treatment planning that is specific to the patient’s needs and disease severity • Rapid access to appropriate care • Engagement in continuing long-term out-

patient care with monitoring and adjustments to treatment • Concurrent, coordinated care for physical and mental illness • Access to behavioral health therapies from trained professionals • Access to FDA-approved medications • Access to non-medical recovery support services Shatterproof is working to help patients navigate to better quality addiction treatment and support medical professionals in adopting best practices. While systemic change is needed to ensure the addiction treatment system operates under these best practices, it is critical to remember that addiction can, and is, treated effectively for millions of Americans. n Samantha Arsenault, VP, National Quality Initiatives, Shatterproof

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