After Durangoan Florence Paillard had surgery on a herniated disk in her back last month, her doctor prescribed Tramadol, an opioid, without any refills.
The limited prescription is evidence of important changes doctors are making to help prevent opioid addiction, said Paillard, a science writer and a clinical scientist with a background in pharmaceuticals.
Prescribing smaller quantities of medications can help keep excess drugs out of medicine cabinets and away from patients, their family members and others who might use them for conditions they weren’t prescribed to treat, she said.
A week after her back surgery, Paillard was satisfied with the pain management provided by a combination of Tramadol and Meloxicam, an anti-inflammatory medication prescribed by her doctor, she said.
“The pain is pretty controlled, and I’m pretty well healed,” she said.
In recent years, pain patients across Colorado and the U.S. who received opioid prescriptions developed lasting and deadly addictions. More than 1,000 Coloradans died by a drug overdose in 2017, a new record. More than half of the deaths were caused by opioids, including 224 caused by heroin and 81 caused by fentanyl, according to the Colorado Department of Public Health and Environment.
Last year in La Plata County, seven people died by overdose involving the use of heroin, methamphetamine and prescription drugs, such as antidepressants, said Kirk Bol with CDPHE.
In 2016, opioids played a role in five La Plata County deaths, according to data supplied by the Coroner’s Office.
To help gauge the scope of the opioid epidemic, the state is tracking the number of times residents in each county are admitted to care for opioid abuse.
In 2016, La Plata County residents were admitted to care on 31 occasions, according to a state report. The state declined to release the number of admissions for opiate-related care in 2017 because the number fell below 30, said Maria Livingston, spokeswoman with the Colorado Office of Behavioral Health.
In Southwest Colorado, opioid abuse was identified as one of the three biggest health problems for residents by the Southwestern Colorado Area Health Education Center based on data and personal interviews, said Mary Dengler-Frey, regional health connector with the center.
Recently, opioid prevention work in La Plata and Montezuma counties has been focused on education for the general public about how to use Naloxone – medication that reverses opioid overdoses, she said.
The center has also organized events for doctors and other health care providers to learn about safely prescribing opioid medications and laws that regulate it, she said.
A new state law approved this year limits the amount of opioid medication a patient can be prescribed to a seven-day supply. The law allows health providers to prescribe more medications for those who have chronic pain, cancer patients and those in palliative or hospice care.
Dengler-Frey is also educating medication prescribers about the state’s prescription drug monitoring program, an online tool that health care professionals can use to look up patients and ensure they aren’t receiving an opioid prescription from another provider, she said.
“The medical community has really gotten behind it,” she said.
Once opioid medication is prescribed, Paillard said she would like to see pharmacists and other professionals providing education for patients about where to safely dispose of medication without throwing it into the trash or flushing it down the toilet. As a patient, she didn’t receive any direction on the disposal of her medication, which needs to be incinerated, she said.
In La Plata County, the Durango Police Department will accept prescription medication for disposal.
Across the state, opioid addiction prevention efforts are the focus of a $15.7 million grant program launched in April 2017 to reduce the number of deaths and increase the number of health care providers capable of treating those with an opioid addiction with medication, Livingston said.
The grant also provides funding for uninsured and indigent clients to receive medication-assisted treatment at 22 opioid treatment programs in the state. The grant has provided treatment to 700 Coloradans, she said.
It has also funded training for more than 300 primary care doctors so they can prescribe medication such as buprenorphine to treat opioid addiction, she said. Buprenorphine reduces cravings, withdrawal symptoms of opioids and weakens the euphoric effect the opioid medications can cause.
Six doctors in Durango use buprenorphine to treat opioid addiction, according to the Substance Abuse and Mental Health Services Administration.
Increasing access to medication-assisted treatment is key because scientific studies have proved it is the most effective method to treat addiction, Dengler-Frey said.