Sarah is one of us: a West Virginia mother who visited her primary care doctor with moderate muscle pain in September 2014. Sarah left with a prescription for oxycodone, one of the most abused drugs in the United States.
What happened next is a true and all too familiar story for West Virginia patients being treated for pain. Sarah’s pain condition did not improve and the excessive opioid dosages worsened her diabetes symptoms.
She developed foot sores and experienced difficulty breathing and swallowing. Her body became increasingly dependent on pain medication as she started filling opioid prescriptions from multiple doctors.
Seven months after beginning opioids for muscle pain, she suffered a tragically preventable and life-threatening opioid overdose. At the time of her overdose, Sarah was taking more than 7 times the maximum opioid dose recommended by the Centers for Disease Control (CDC).
Sarah is one of us, and what happened to her is happening to thousands of West Virginians today. Opioid misuse has grown into a national crisis, as evidenced by President Obama’s emotional visit to West Virginia last year. West Virginians have been more devastated by opioid misuse than not only any other state in America but more than any place on the planet.
Over 600 opiate-related deaths occurred in West Virginia last year alone. Unintentional overdose deaths from prescription pain relievers have more than quadrupled here since 1999, and heroin-related deaths are nearly 30 times higher than they were just a decade ago.
According to the CDC, West Virginia ranks first in rates of neonatal abstinence syndrome (babies born drug dependent) at 33.4 per 1,000 births, over five times the national average. These are shocking facts, but they are not just numbers. These are the lives of West Virginians like Sarah — our friends, family members, co-workers, neighbors, sons and daughters.
As bleak as the West Virginia opioid misuse picture is, solutions exist and are within reach. Focus should be on prevention, early intervention, evidence-based treatment, access to quality care and support during recovery. Education of health care professionals, government officials and the general public is critical to curb the abuse and misuse of opioids.
The recent Appalachian Addiction & Prescription Drug Abuse Conference began educating and promoting the CDC-recommended guidelines to treat chronic pain more appropriately. Marshall University has recently announced the creation of a faculty position to treat dependency, and they have combined with the WVU School of Medicine to offer educational opportunities to students aimed at improving clinical practice for chronic pain and opiate withdrawal treatments.
As Medical Director for Highmark Blue Cross Blue Shield West Virginia, I’ve partnered with axial Healthcare, an innovative pain medication and pain care solutions company, to bring an evidence-based quality improvement program to Highmark health care providers in West Virginia. The program educates and supports providers on safe practices, provides feedback around their current opioid prescribing and delivers alerts when there’s an instance of intensifying patient risk.
Highmark West Virginia is reducing opioid misuse and treating dependency by starting with step one — education and support. Giving health care providers much-needed knowledge and resources will lead to safer and more effective pain treatment for patients like Sarah in the future.
On November 9 in Charleston, the Highmark Foundation and axial Healthcare are hosting an opioid solutions forum titled, “Altering the Course: Solutions for the West Virginia Opioid Misuse Crisis.” The Forum will convene national and community leaders for a fact-based, problem-solving discussion around encouraging appropriate pain treatment, reducing opioid addiction, and improving access to addiction treatment and recovery for West Virginians.
During the flood in June of this year, I was deeply moved by the many ways West Virginians helped and supported each other. We must face this crisis in the same way: united together. Encouraging those misusing or dependent on opioids to seek help is a good place to start. West Virginia has a strong culture of loyalty and community. The way we go about resolving the opioid misuse crisis should reflect that spirit.
Norman Montalto, D.O., is the medical director for Highmark Blue Cross Blue Shield West Virginia and practicing physician at Family Care in Charleston.