Vail panel: Opioids have limited role in medicine |

Vail panel: Opioids have limited role in medicine

Unsorted prescription pills sit in a pharmacist's counting tray before they are bottled.
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Source: Colorado Consortium for Prescription Drug Abuse Prevention

EDWARDS — Legitimately prescribed opioid painkillers are the very definition of a slippery slope. Used as intended, those drugs are a powerful tool in pain management. Used improperly, the drugs are a gateway to mental illness, addiction and, sometimes, death.

Vail Health on Wednesday, May 23, hosted a panel discussion on the topic of opioid use and abuse. The discussion featured speakers from a variety of professions, from social service and treatment to medicine to the state agency trying to fight the epidemic of opioid abuse.

The discussion focused on prescribed drugs. That’s the gateway to use of illegal drugs including heroin and fentanyl.

According to Becky Larson, of the Eagle County Department of Health and Human Services, opioid overdose deaths in Colorado have quadrupled since the year 2000. Recent reports indicate that more than 200,000 state residents are addicted to, or abusing, opioid drugs.

Larson noted that about 75 percent of heroin addicts surveyed say they used prescription opioids before turning to street drugs.

Kris Vandenberg, of Mind Springs Mental Health, also has her own practice, New Beginnings Mental Health. She sees numerous patients battling both addiction and other mental health issues.

“There’s a place for pain management, but we have to be very vigilant,” Vandenberg said, adding that 10 percent of people who take opioids for 30 days or more start to develop signs of clinical depression.

Understanding patients’ needs

That’s why it’s important for doctors to understand their patients and what they’re experiencing.

Dr. David Ruttum, of Anesthesia Partners of Colorado, told the audience opioid drugs can be useful immediately before, during and right after surgery. But, he added, opioids’ usefulness quickly fades

In the case of orthopedic surgery, Ruttum said opioid drugs lose their effectiveness as patients start physical therapy. Patients can take opioids for roughly five to seven days without risk, Ruttum said. After that, the risk increases.

When patients begin moving after surgery, over-the counter pain relievers including Advil and Tylenol can be effective, as can non-narcotic prescription drugs including Lyrica.

Mixing up medications is relatively new, Ruttum said. In the 1990s, accepted practice was just to prescribe higher doses of opioids.

“We didn’t do people any favors,” he said.

These days, using smaller doses of different medications can be more effective.

Ruttum said that while many patients believe medical marijuana can ease their reliance on opioids, there’s no clinical evidence to support the claim.

In addition to medication, Dr. Stephen Godar, a hospitalist at Vail Health, said he’s also seeing good results from acupuncture, breathing and similar treatments.

“I’m not suggesting people can think away their pain,” Godar said. But people can use their minds to activate pathways to help with pain management.

“Pain is debilitating,” Godar said. “We need to use all the modalities we can.”

Combating abuse

Still, people will abuse opioid drugs, either legally or illegally. The cost of that abuse is staggering. Whit Oyler, a representative of the Colorado Consortium for Prescription Drug Abuse Prevention, said the 2015 cost of the opioid epidemic in the United States was estimated at more than $500 billion. That’s roughly equivalent to the country’s annual defense budget.

To help, the consortium has rolled out a number of online and in-person resources, including prescription-drug disposal sites. Locally, the green-box drop-off sites are at the offices of the Vail and Avon police departments and the Eagle County Sheriff’s Office in Eagle.

Medications dropped off at those sites are shipped to the eastern United States and incinerated, Oyler said.

Safe drug disposal is important to keep medications out of the hands of people who aren’t supposed to have them. But, Oyler said, it’s also important to keep those drugs away from pets. Nearly one-third of calls to pet poison control centers are for prescription drugs.

While Larson said Eagle County hasn’t been seriously affected yet by the opioid crisis, one member of the audience cautioned people against complacency.

Judge Peter Dunkleman runs the drug court in Eagle County. He told the group that there is a problem in the county.

“Heroin is here, and it’s part of the opioid epidemic,” he said.

Larson said that’s true. But, she added, trying to keep people from abusing prescriptions is an important first step.

That’s “where we can move the needle,” she said.

Vail Daily Business Editor Scott Miller can be reached at 970-748-2930 or

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