Appropriate and efficient medical care is difficult to provide in populations suffering an epidemic of opioid addiction. The escalation of such an epidemic is especially difficult to stall in certain regions of the United States where the relations between doctors and patients have been fortified due to long-term acquaintanceship; it is difficult for a doctor who has known a patient for an extended period of time – perhaps since childhood – to deny the requests of opioid prescriptions. Such a phenomenon can be observed in the rural setting of West Virginia, which is spotted with primary care clinics tending to localized communities.
Dr. Sarah Chouinard, chief medical officer of Community Care of West Virginia and overseer of multiple rural primary clinics across the state, expressed concern in attempting to get patients of the rural clinics to focus on their health issues during a visit instead of on their pain and the ensuing course of medication, often gravitating toward suggestion of opioid prescription. In order to overcome the dilemma that primary care physicians faced in providing correct treatment due to patient focus on chronic pain, Community Care hired Dr. Denzil Hawkinberry, an anesthesiologist, to treat chronic pain. Thus the load of concentration on chronic pain has been lifted from the shoulders of primary care physicians within the Community Care medical organization, allowing them to focus on other health problems their patients suffer, in an especially disproportionately poor population.
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In a state that has been the hotbed of opioid abuse in the United States, Dr. Denzil Hawkinberry is an optimal choice in the position of anesthesiologist within Community Care, adhering to patients’ health problems while using his own experience with opioid addiction as a driving force in pursuing treatment options lacking opioid medication. In addition to treating new patients’ chronic pain without opioids, Dr. Hawkinberry also aims to reduce the dosages of those already taking them. 70 percent of 1,200 patients already utilizing the pain management program use opioids as part of their treatment plans. The screening of opioid abuse in patients is very precise under the experience of Dr. Hawkinberry, as patients follow strict organization regulations such as submitting urine samples at each monthly appointment and even at random times, as well as bringing in their pills to be counted. Community Care is not the only organization in the state of West Virginia to implement such a rigorous supervision of opioid use, as its pain management clinic is actually only one of six within the state of West Virginia that abides by a law implemented in 2012 to crack down on illegitimate distribution of narcotics.
Physicians within the Community Care organization benefit from an electronic medical record system that allows not only for cross-referencing and widespread data sharing between the physicians themselves, but also an instant-messaging feature that provides efficient communication. Poor inter-physician communication within the organization was also alleviated by the hiring of Dr. Hawkinberry, as now patients do not need to be sent to pain specialists outside of the organization. To date, more than 3,000 of the organization’s 35,000 patients have been able see Dr. Hawkinberry and determine viable pain management treatment options provided by Community Care, with great help from physicians’ ease of navigation within the superior communication system.
Although prescription of opioids to treat chronic pain can be forestalled and even averted completely via other treatment methods such as physical therapy and psychological care in organizations such as Community Care, similar pain management programs are lacking throughout the country. Lack of sufficient pain management programs leads to very long delays in appointments with a pain specialist. Even in Community Care’s program, the extremely high demand causes patients to wait up to six months for an appointment regarding pain treatment. Waiting time is augmented of course by proper assessments of patients’ previous or current opioid prescriptions and risks of addiction. The necessity for national pain management systems such as Community Care’s system requires more physicians and efficient communication systems within and even across organizations, in order to provide appropriate medical care for patients suffering from chronic pain while at the same time halting the epidemic of opioid addiction.
David Grecu is a senior at the University of San Francisco, pursuing a Bachelors of Science in Biology with a minor in Neuroscience, focusing on a pre-medical curriculum. His career intent is to enter the field of healthcare with a scope in socially and economically disadvantaged communities. He is a Social Media Assistant at Cancer InCytes Magazine.
Goodnough, Abby. “Treating Pain Without Feeding the Epidemic of Opioid Addiction.” The New York Times 13 May 2016, National ed.: A1+. Print.
Photo Credit: Janaburson’s Blog: https://janaburson.wordpress.com/category/history-of-opioid-addiction/