Address patient shame, stigma when treating opioid misuse

Troy Parks
Staff Writer
AMA Wire
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Assessing risk for opioid misuse, treatment of chronic pain and the role of shame in patients with opioid use disorders are just three of the topics covered in a collection of resources from a national training and mentoring project developed by physicians to promote the fundamental role of self-education and in curbing the opioid epidemic.

New educational resources from the Prescribers Clinical Support System for Opioid Therapies (PCSS-O) address key issues surrounding the treatment of chronic pain and stigma, and help physicians learn new techniques and reinforce what they are already using in clinical practice.

Two webinars recently added to the PCSS-O collection are:

  • The Role of Shame in Opioid Use Disorders. In this webinar from the American Academy of Addiction Psychiatry (AAAP), Ashley Braun-Gabelman, PhD, of the University Hospitals Case Medical Center in Cleveland, explains how patients with opioid use disorders come to feel shame and guilt and why that is often hard for physicians and family members to recognize. Dr. Braun-Gabelman delves into how to identify when a patient is feeling shame through nonverbal indicators and body language, and offers questions that may help a patient talk about their feelings of shame. She also explains the shaming atmosphere among different populations of people with opioid use disorders.
  • Addiction Prediction: Errors from the Bedside Hurt Patients with Pain. Renee Manworren, PhD, director of nursing research at Lurie Children’s Hospital of Chicago, describes three types of concerning findings from a study of home postoperative pain management that explored the difference between patient pill-use logs and actual pill counts.

    Gaps in knowledge regarding the risks for opioid misuse and addiction and how nurses’ concerns for addiction may alter opioid medication administration practice are detailed in this webinar.

Two modules recently added are:

  • Concurrent Management of Chronic Pain and Addiction. In this module from the American Academy of Pain Medicine (AAPM), Larry Driver, MD, of the University of Texas Department of Pain Medicine, and Lynn Webster, MD, vice president of scientific affairs at PRA Health Sciences in Salt Lake City, present treatment strategies that meet the unique needs of patients who suffer from chronic pain and addiction. Drs. Driver and Webster teach physicians how to incorporate risk-assessment tools when managing patients with chronic pain, use information from the tools to stratify patients’ risk for abuse and addiction and implement an individualized pain management plan for patients with addiction that addresses risk and integrates many factors in the context of available resources.
  • A Review of Considerations in the Assessment and Treatment of Pain and Risk for Opioid Misuse. Elinor McCance-Katz, MD, PhD, professor of psychiatry at the University of California San Francisco, provides a historical overview and context for the current opioid misuse epidemic and how to resolve the need for effective pain treatment while still minimizing opioid misuse in the evaluation of a patient’s pain. Dr. McCance-Katz also delivers an in-depth anatomical explanation of pain and pain’s psychosocial aspects that can help physicians better evaluate and develop treatment plans for patients with pain.

As Chair of the AMA Task Force to Reduce Opioid Abuse, Patrice A. Harris, MD, has made clear the importance of physician education and training to prescribe controlled substances safely and appropriately and help patients with substance use disorders access the treatment they need.

“Physicians understand their vital role in ending this crisis as both a professional and ethical obligation,” Dr. Harris wrote earlier this year in an article for The Hill. “If physicians do not know where to find education that applies to their practice and specialty, many organizations are available to help.”

Numerous modules and webinars are available and new resources are added each month to the PCSS-O collection. The AMA is a member of the PCCS-O Steering Committee.

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