Battling prescription drug abuse in orange county

UCI Health has helped launch a countywide initiative aimed at curbing opioid drug abuse and assisting patients who are dependent.

What began about 15 years ago as a well-intentioned campaign to better treat people with chronic pain has today mushroomed into an epidemic of prescription drug abuse across the country.

U.S. deaths from prescription painkillers, typically opioid medications, quadrupled from 1999 to 2013, according to the federal government.

This grim picture is much the same in Orange County. That’s why UC Irvine Health has helped launch a countywide initiative aimed at curbing opioid drug abuse and assisting patients who are dependent.

“As a pain physician, having seen this problem evolve, I can’t help but feel the need to play a prominent role to reverse this trend,” says Dr. Padma Gulur, director of the UCI Health Center for Pain Management & Wellness.

Gulur has led the effort to establish the Orange County Collaborative on Prescription Drug Abuse. The coalition, which was founded late last year, is made up of health professionals, educators, health insurers, law enforcement officials and others who are joining forces to address the opioid drug abuse problem in Orange County.

No region of the nation is free from prescription drug abuse, Gulur says. According to a 2014 report from the Orange County Health Care Agency and Sheriff-Coroner’s Office, the rate of drug overdose deaths increased 61 percent between 2000 and 2012.

“It’s affecting every strata of society,” she says. “It’s no longer someone else’s problem.”

In her own practice, Gulur works with patients to identify a range of options to alleviate pain. For too long, however, physicians around the country relied heavily on prescribing opioids.

“Back in the 1990s there was a concern that we were under-treating pain. From 2003 to 2008, prescription drug use went up dramatically,” she says. “Science has taught us that pain requires multimodal care: complementary and alternative medicine, lifestyle modification, nutrition as well as medications or medical interventions. But there has been a tendency to rely almost exclusively on this class of medications.”

Anyone can become addicted, she adds. “It’s the medicine, not the people. This is what these medications do to our system. Addiction can affect anybody.”

The collaborative includes individuals who have experienced the heartbreaking toll of prescription drug abuse in their families, such as Aimee Dunkle, executive director and co-founder of the Solace Foundation of Orange County. The foundation works to reduce overdose deaths through the use of naloxone, a potentially lifesaving medication that can be administered to someone suffering an opioid overdose. Dunkle’s son died of an opioid overdose in 2012.

“If you look at the statistics on opioid drug abuse in California, it doesn’t look that bad,” Dunkle says. “But when you look at counties separately, like Orange County, you realize there are pockets with unbelievably high overdose rates. The collaboration represents the community coming together to do something.”

The group will focus on training doctors about “safe prescribing practices” to treat pain while minimizing the risk of addiction. Efforts will be made to educate people on the proper storage and disposal of opioids.

The collaborative aims to improve the treatment options for Orange County residents who are addicted to opioids and to increase the use of naloxone.

“When my son overdosed three years ago, he was with three people who did nothing. If they had naloxone, they would have used it,” Dunkle says. “The collaboration can work on getting the funding and support for distributing naloxone.”

The group hopes to see a 20 percent drop in opioid deaths, which are usually accidental, in 18 months. Similar initiatives have been successful in Marin and San Diego counties. UCI Health is a natural choice to lead the Orange County campaign, Gulur says. “We are the academic institution for this area,” she says.

“We are training the next generation of physicians and prescribers. We need to lead by example. While we have done a lot within our own health system to address this issue, we have to recognize that we are one part of a larger community and we have to address the larger problem.”

The coalition, which has been funded by a grant from the California Healthcare Foundation, is off to a strong start, she adds. “Seeing everyone come together is very fulfilling. When I have picked up the phone or asked to meet someone, I’ve seen nothing but open-hearted support to try to address this.”

Learn more about the Orange County Collaborative on Prescription Drug Abuse at saferxoc.org and about pain management at ucirvinehealth.org/pain.

— UCI Health Marketing & Communications
Featured in UCI Health Live Well Magazine Summer 2016