PA Educates Patients at Behavioral Health Center for Addiction Medicine Treatment

PA Foundation Supports PAs With Patient-Focused Resources for Safe Opioid Use

The numbers surrounding the opioid epidemic continue to tell a sobering tale. According to the American Society of Addiction Medicine, drug overdose is the leading cause of accidental death in the U.S.; there were 52,404 lethal drug overdoses in 2015 alone. And on April 5, the Office of the Surgeon General released its first nationwide advisory in 13 years – a specific call to arms regarding the opioid epidemic.

The opioid crisis is rightfully in the national spotlight, and PAs and all healthcare providers are on the forefront of the fight. Since PAs practice in every state and in every medical setting and specialty, their contributions are critical to curbing the opioid epidemic.

In an effort to educate Americans and stem the tide of the opioid epidemic, the PA Foundation has partnered with nine other healthcare organizations to launch Allied Against Opioid Abuse (AAOA), “a national education and awareness initiative to help prevent the abuse and misuse of prescription opioids.” AAOA’s goal “is to contribute to solving the opioid crisis in a meaningful way by educating patients about the rights, risks, and responsibilities associated with prescriptions opioids.”

The PA Foundation also strives to empower PAs to address substance-use disorders through its grant programs. For the past two years, the Foundation has partnered with the National Institute on Drug Abuse (NIDA) to offer the NIDA Mentored Outreach Award in Substance Use Disorders (SUD) Treatment Dissemination. This award supports the development of PAs’ expertise in SUD through completion of a mentored experience and project that disseminates existing evidence-based treatment science. Sandra Alexander, PA-C, who has spent most of her PA career focused on addiction medicine, received a 2016 NIDA Mentored Outreach Award for her project focused on developing and implementing a pilot integrated recovery services program.

An unusual path

Alexander did not start her career as a PA. She graduated from college with a degree in chemistry and took various positions in pharmaceutical labs “to get the instrumentation experience needed to work in forensic labs.” She trained at the Regional Counterdrug Training Academy in Meridian, Mississippi, and ultimately ran her own crime lab, where she analyzed not only crime scenes but also hazardous materials, forensic drug and toxicology samples, and illicit drug labs. It was during this time, Alexander says, that she realized “many drug cases and illicit drug labs had repeat offenders. No one was offering any intervention – only legal repercussions.” One day, a woman whose daughter died of an overdose made a statement that changed the course of Alexander’s life: “My daughter was constantly asking for help and no one helped her.”

Recognizing a need

Alexander decided she “wanted to approach community drug problems through medical intervention” and chose to practice medicine as a PA in order to do so. She graduated from Campbell University’s PA program and immediately started working in addiction medicine. She worked for opioid treatment programs (OTPs) and other psychiatry practices that provided substance use disorder treatments. Ultimately, however, Alexander realized she had a unique vision for a behavioral health treatment center and wanted to do it her own way. In June 2017, she opened Collegial Behavioral Health in Raleigh, North Carolina. At her practice, Alexander says, “I can surround my patients with a team. We offer medication management, counseling, and lab services to help provide patients with unified support in a welcoming atmosphere during their recovery efforts.”

Alexander’s practice provides in-house lab testing, counseling, and treatment for psychiatric and substance use disorders. She encourages patient participation by making counseling appointments less expensive than medication follow-ups. Alexander believes counseling “will help patients create new behavioral strategies and coping skills so they don’t continue to respond to obstacles and triggers in the same way.”

Alexander recognized a need in her own community and, as a PA, was able to use her medical expertise to address it. She says PAs are in an advantageous position to prevent abuse and misuse of opioids because “they can educate their patients and take the time to explain the risks.” She goes on to say that “more people are becoming aware of the opioid epidemic but there are still some who think it can’t or won’t affect them.” PAs have skills that allow them to screen patients and discuss their symptoms so that opioid dependence, or the risk of it, can be recognized early. This also helps them to understand when to offer alternative pain medication or pain-relief therapy, she says.

Addiction medicine resources for PAs

If you are a PA interested in getting involved in substance use disorders, Alexander recommends reaching out to AAPA’s Society of PAs in Addiction Medicine or your local chapter of the American Society of Addiction Medicine. For PAs who do not practice near others practicing in this field, many like-minded healthcare professionals can be found online. Alexander herself founded an online group using Google’s web forums; now, 47 professionals in various specialties meet every other month in the Raleigh/Durham area.

Alexander has also found the Allied Against Opioid Abuse resources helpful in her own practice. “Part of the PA role,” she says, “is to educate our patients. AAOA puts resources in our hands quickly and effectively.” The AAOA tools remind PAs to educate patients about their personal responsibility to secure opioids at home and dispose of them safely if there are leftovers. Alexander stresses that proper disposal is extremely important. Many of her teen and young adult patients first started abusing opioids in either their own home, or the homes of relatives. It’s human nature to believe “it won’t happen to me,” so it’s important to have these conversations with patients, family members, and caregivers. The AAOA materials help providers have these conversations that protect patients and their loved ones.

PAs are needed now, more than ever, to prevent abuse and misuse of prescription opioids. Read more from Alexander about how PAs can get involved, and access the Allied Against Opioid Abuse resources for patients and providers online.

Kate Maloney is AAPA’s senior manager of corporate communications.

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