UNM-IHS opioid training
Fore (left), Katzman and Bhatt conduct telehealth training with more than 100 Indian Health Service prescribers.

The University of New Mexico and the Indian Health Service are teaming up to tackle opioid abuse among Native Americans using telehealth technology to share best practices in chronic pain management with health care providers.

Under a new agreement, UNM is providing expanded training to more than 1,200 IHS prescribers in hopes of reducing the disproportionate misuse of opioids among Native Americans.

“This IHS training is very important to the Native American population across the U.S. and to New Mexico’s 29 pueblos and the Navajo Nation,” said Joanna Katzman, MD, director of the UNM Pain and Consultation and Treatment Center.

“Our approach is to continue treating legitimate chronic pain – that’s important – but through best management practices that offer alternatives to opioids and safer, more responsible use of opioids when all else fails.”

The new IHS training program builds on Katzman’s efforts to educate prescribers throughout New Mexico on the safe use of opioid painkillers in response to the state’s skyrocketing rate of drug overdose deaths. She has published research showing that the quantity of opioids dispensed in the state declined after prescribers underwent the training.

Katzman and her team deliver the training via UNM’s Project ECHO telehealth service. More than 1,800 IHS, tribal and urban providers already have that course under their belts, said Chris Fore, PhD, director of the IHS Telebehavioral Health Center of Excellence in Albuquerque at a recent training session.

The newly developed IHS course is a more detailed version, developed in collaboration with the agency at the request of its prescribers, Fore said.

“Through telehealth, we can reach our IHS prescribers – physicians, nurse practitioners, physician assistants, dentists and behavioral health practitioners – with updated guidelines for treating chronic pain,” he said. 

“We’ve found a way to reach out to our providers without having to fly them in to a central location at great expense. It would be cost- and time-prohibitive for us to quickly and effectively train our medical professionals any other way.”

Chronic pain related to ailments that include headaches, back and joint pain and fibromyalgia, affects an estimated 100 million Americans at a cost of up to $635 billion annually. It is a public health crisis that affects more people than diabetes, cancer and heart disease combined. But the misuse of prescription pain killers to treat these maladies has created an epidemic of drug abuse and overdose, especially among Native Americans.

An estimated 4.2 percent of Americans 12 years and older misuse hydrocodone, oxycodone, morphine, codeine and other powerful pain killers, but nearly 7 percent of the American Indian population misuses them. The majority get hooked on these powerful medications when friends or relatives share pain pills or fail to properly secure them.

The six-hour HIS training provides feedback from participants to gauge the program’s effectiveness. It includes an overview of the problem, screening for opioid addiction or misuse, alternative treatments for pain, safe prescribing practices, federal regulations in prescribing opioids and an all-important question-and-answer session.

Katzman and Fore share each training session with other UNM faculty members, including Snehal Bhatt, MD, an addiction psychiatrist, George Comerci, MD, who developed the telemedicine pain curriculum, Chris Camarata, MD, a geriatric and chronic pain expert, pharmacist clinician Ernie Dole, PharmD, and pediatric rehabilitation specialist Denise Taylor, MD.

“A presidential memorandum was released late last year directing all federal medical professionals with prescribing authority to receive adequate training on appropriate pain medication prescribing practices,” Katzman said. “We anticipate the reach of this program to extend to all federally employed and contracted prescribers.”