EMS World

JUL 2018

EMS World Magazine is the most authoritative source in the world for clinical and educational material designed to improve the delivery of prehospital emergency medical care.

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THE OPIOID CRISIS 42 JULY 2018 | EMSWORLD.com T here's an epidemic ravaging Ameri- can lives that's related to but dis- tinct from the opioid crisis, and EMS providers encounter it often in their patients and sometimes firsthand: Chronic pain impacts around 100 million Americans and costs an estimated $635 billion per year in medical expenses and lost productivity. 1 For too many Americans this condi- tion has been treated with nothing but increasing amounts of opioids. Now, with addiction and overdoses and associated problems rampant, clinicians are looking far more skeptically at what we're pre- scribing and to whom, and with far more interest at other ways to address chronic pain. "What we've done is tremendously overmedicalize chronic pain," says Ben Bobrow, MD, FACEP, distinguished profes- sor of emergency medicine at the Univer- sit y of Arizona College of Medicine and medical director for the Arizona Depart- ment of Health Ser vices' Bureau of EMS & Trauma System. "We just assume ever y- one needs opioids, and that's been part of the issue. That's a terrible disser vice we in the medical industr y have inadvertently done to people. I'm not saying we should never use opioids, but we need to be way more judicious about whom we give them to and how much." There are better options. While chronic pain may not be completely eliminable, diet, physical activity, and cer tain long- term therapies have shown promise in helping people manage it. Such alternative strategies are at the hear t of The Pain Project, a new ef for t Bobrow is spearheading to make expert advice and alternative treatments avail- able to sufferers of chronic pain, including first responders. Most notably it of fers "telepain therapy"—virtual connection to remote experts who can securely coun- sel victims through treatment strategies ce nte re d aro u n d m in d f u ln e s s- b a s e d approaches designed to restore a sense of control and get people back to pursuing meaningful, enjoyable activities. "When people are hopeful and engaged and tr ying," says Bobrow, "that can cause a critical change in mind-set that actu- ally helps us feel better. But it's not about being a pa s sive recipient of care—it 's more about engaging and becoming the director of your own care." Taking that ownership is vital to nono- pioid approaches. Chronic Pain and Its Impact EMS providers likely understand the dif- ference between chronic and acute pain. Acute pain results from an injur y and is generally of limited duration. Chronic By John Erich PUT DOWN THE PILLS: SEEKING BETTER APPROACHES TO TREATING CHRONIC PAIN The Pain Project promotes safer, more eff ective alternatives to opioids and helps connect suff erers to help

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