Patients at risk of opioid dependency are in your practice. Let me repeat this. Patients at risk of opioid dependency are in your practice. The good news is that we can manage those risks through basic chronic disease management approaches.
The reality is that we will have patients that require pharmacological interventions for their acute or chronic pain. It’s also likely that we’ll have patients that are using substances recreationally or due to substance use disorder, and that may put them at risk of mortality.
In primary care—as generalist providers of comprehensive and, often, complex care—we need to look to simple practice change and new partnerships to make huge impacts for our patients.
- Start with a conversation. We have trusted, long-term relationships with our patients and if we open the door to allow open and honest dialogue about where they are struggling, it can be the first steps into the prevention and management processes. It may, perhaps, be similar in nature to discussing smoking cessation with your patients where highlighting the benefits of quitting (rather than the dangers of continuing) is the most effective way to a solution that works for them.
- Partner with others in your clinic and community to create your care teams. It may take some time to build the relationships, education, and experience to create a functional care team that works but it will pay off in spades. Consider building “integrated care partnerships” with your patients and others in your community (even if you have to look to AHS or PCN resources outside of your practice) that have the needed expertise. That’s what they are there for.
- Build your capacity as a team. There are, and will continue to be many, opportunities in the coming years to build capacity in opioid management, including harm reduction, diagnosis, and treatment (such as opioid replacement therapy and prevention). Look for sessions—conferences, workshops, or online—that you and your team can participate in to gain skills and best practices.
- Bring in facilitators to help redesign your practice. Health care, including family medicine, is changing and we need to become increasingly agile to adapt to the changes, but you don’t have to do it alone. Your PCN and the AMA have an army of practice facilitators and change agents that are well-equipped to support your clinic in a rethink/redesign process.
Here at the ACFP, we are working with our partners—PEER, AMA, PCN Zone Committees, AHS (Provincial, Zone, and Community Programs), and Alberta Health—on the Primary Health Care Response to the Opioid Crisis. We want to make sure that we are providing the supports and resources that you need and are looking to you to let us know where your challenges are, where you’ve been successful in your own practice in responding to the crisis, and what we can do to help.
Call or email Terri Potter, our Executive Director, any time.