Dr. Stacy Caudill speaks on opioid issues at Rotary.

ASHLAND Reversing the upward trend of opioid abuse requires new approaches to dependency, including at the hospital level, according to a King’s Daughters Medical Center physician.

They include better access to treatment, changes in pain treatment, and monitoring of patients and their opioid use, hospitalist Stacy Caudill said Monday at the Ashland Rotary Club.

King’s Daughters is working on several initiatives, some involving long-time drug abusers and others involving patients whose exposure to opioids comes after surgery or other pain-inducing medical care.

The hospital is able to provide Narcan at no charge from its pharmacy through a grant from the Kentucky Opioid Response Effort, which is a program of the state Cabinet for Health and Family Services.

Narcan is the brand name for naloxone, a medication that blocks the effects of opioids and can prevent death from overdose if administered in time.

That means patients — or their family members —  who come to the emergency room after an overdose can get Narcan from the hospital pharmacy, she said. Along with that, patients can get counseling, she said.

Physicians associated with KDMC are increasingly using Vivitrol, a non-narcotic drug used in treating patients trying to kick opioid addiction, she said. The drug reduces the craving for Opioids but does not produce a high, she said.

Physicians also are increasingly looking for non-narcotic pain treatments, and for decreasing the number of doses prescribed for patients recovering from surgery, she said.

Studies show many patients recovering from surgery do not use all, or even most of the pain medication prescribed, she said.

That raises the potential for misuse of leftover opioids. King’s Daughters includes with all its narcotics prescriptions a device called DisposeRX for the safe disposal of leftover medication.

The device dissolves leftover drugs and combines them with a proprietary material in a gel form that can’t be used but can be safely thrown away.

The amount of leftover, unused opiates in Kentucky medicine cabinets is unknown, but what is known is the high rate of prescriptions — 2017 data indicates 86.8 opioid doses were prescribed per 100 people in Kentucky, she said.

Caudill called for a cultural shift in views toward addiction: “The biggest thing is to change the way we think, act and talk about people with substance abuse disorder. We need more empathy and compassion. It’s a disease. That’s the piece that can be missed,” she said.

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