AAOA welcomes guest bloggers to share their perspectives on how to address prevention of misuse and abuse of prescription opioids. This post is the first in our “Spotlight Series” on how PAs across the country are working to raise awareness about the rights, risks and responsibilities associated with prescription opioids. Our first post comes from Rafael Pomales, MHS, PA-C, DFAAPA, who is President of PAs for Latino Health; and Robert S. Smith, MS, DHSc, PA-C, DFAAPA, Treasurer and Co- Founder of PAs for Latino Health.
Opioid Crisis Among Hispanic Populations
A recent report from the Substance Abuse and Mental Health Services Administration (SAMHSA) called the opioid crisis among Hispanic/Latino* populations an “urgent issue,” and described the unique challenges faced by this population — including intergenerational and intercultural differences within households, language barriers, and stress related to migration and discrimination. As the fastest growing minority population in the U.S., it is imperative that the public health community better understand and address these challenges to not only curb the opioid epidemic but improve the overall health of Hispanic/Latinos across the country.
As PAs serving the Hispanic community, we are very familiar with these challenges and appreciate the opportunities we have to help our patients navigate the healthcare system. While we often talk about the opioid epidemic at a national or state level, the interactions patients have with their healthcare providers are truly the most meaningful moments and present the best opportunities to prevent future challenges.
We frequently work with patients who have been prescribed opioids for chronic or acute pain or will soon undergo surgery that may require opioids for pain treatment. We start by talking to our patients and their caregivers about the treatment options available for pain — from physical therapy to over-the-counter pain medication. For those who require prescription opioids, we talk about the rights, risks and responsibilities associated with them, and answer any questions they may have.
Safe Storage and Disposal Especially Important During COVID-19 Pandemic
While the past year has been challenging for all of us, it has been especially difficult for patients using prescription opioids. In fact, data from the Commonwealth Fund indicate that in May 2020 — only two months after the COVID-19 pandemic started — monthly overdose deaths from all drugs increased by more than 50 percent to 9,000 deaths. As more data are collected, 2020 is on track to reach more than 90,000 overdose deaths — the largest increase in 20 years. Hispanic adults have experienced the highest levels of depression and suicidal thoughts among racial and ethnic groups during the pandemic. It is important to consider these challenges when treating patients, as they may contribute to opioid abuse and misuse.
Stay-at-home orders over the past year also made safe storage and proper disposal of prescription opioids even more important. More children have been at home and more adults have faced social isolation, which sadly can often lead to substance misuse. With more than one-quarter of Hispanic/Latinos living in multi-generational households, it is critical that healthcare providers discuss how to safely store prescription opioids at home and how to safely dispose of unused medication.
Bilingual Toolkit Available to Help Educate the Hispanic Community
To best reach Hispanic communities, we know that educational materials should be both culturally appropriate and bilingual. Allied Against Opioid Abuse (AAOA) developed a suite of resources to help educate the Hispanic community about the rights, risks and responsibilities associated with prescription opioids. To ensure the resources meet the needs of those who will use the tools, AAOA partnered with the National Hispanic Medical Association (NHMA) to convene an advisory committee of healthcare professionals who care for Hispanic patients daily and work in their communities. The resources are available in both English and Spanish and were written specifically for the Hispanic community.
The toolkit includes a resource on Safe Storage and Disposal of Unused Prescription Opioids (Guardar y Deshacerse de Forma Segura de los Opioides Recetados) that provides guidance on how to prevent opioids from getting into the wrong hands. Additionally, there is a Guide to Managing Pain After Surgery (Guía para Controlar el Dolor Después de una Operación) that is helpful for patients preparing for and recovering from surgery. For those that prefer to receive information visually, AAOA also developed an informational Spanish-language video providing key insights on safe prescription opioid use from NHMA physicians (La prescripción de opioides: lo que necesita saber).
Especially helpful to us is the Questions About Opioids? resource (¿Tiene Alguna Pregunta Acerca de los Opioides?). It is very important that Hispanic patients feel comfortable asking questions related to other drugs they are taking and any side effects they may experience. Too often there is stigma associated with asking for help or seeking follow-up care, and part of our job is to let patients know that the best way to stay healthy is to stay informed. The fact sheet also reviews what opioids are, how they work and key signs of an opioid dependency.
We encourage healthcare providers to share these tools with their patients and emphasize the importance of patients reviewing the questions to make sure they are comfortable with prescription opioids. Together, we can continue to better educate our patients, prevent prescription opioid abuse and misuse, and make our communities healthier.
*In this post, the term Hispanic/Latino is used as an umbrella term to include those who identify as “Hispanic,” “Latino,” and/or “Latinx” in the U.S.