ASTORIA, Ore. - A new pain-management clinic in Astoria is the latest step in a statewide effort to curb an epidemic of pain medication abuse in Oregon.

The state is ranked first in the nation in deaths from pain prescription overdoses. Many drugs prescribed legally for chronic conditions lead to addiction or are diverted to other users illegally.

The North Coast Pain Clinic integrates traditional medicine with physical therapy, psychological services and non-drug methods of easing chronic pain. Mark Altenhofen, project manager, said it's an alternative not only for patients but for doctors wary of prescribing painkillers.

"We're seeing docs say, 'Well, I'm not treating pain at all,' in some cases," he said. "And it's really sad, because the prescription is just one part of the tool. Even in primary care, you can still support that patient even if you decide not to prescribe. There are other ways to help address the issue."

From 2000 to 2012, according to a state report, almost 4,200 Oregonians died of an unintentional or undetermined drug overdose, and more than 15,000 were hospitalized. It recommended early identification of people with addiction problems, and better coordination of behavioral and physical health care.

Dr. Anne Alftine said Coordinated Care Organizations such as Columbia Pacific on the North Coast or Jackson CareConnect in Medford, where she works as director of clinical strategy, are serving as catalysts to integrate the different types of care. One goal is to work more closely with addiction treatment providers. In much of the state, Alftine said, they're in short supply.

"It's been under-funded for a number of years," she said, "and that's one of the things we're looking at: How do we partner with them in better ways, in connecting primary care and addiction services? How do we work together as partners, in helping these patients get the care that they need?"

According to a national survey on drug use and health, only about one in 10 people who need specialized substance abuse treatment get it from a specialized facility. Alftine said that's more proof of the need for coordinated care.

Dr. Jim Shames, medical director for Jackson County Health and Human Services, said Oregon is taking other innovative approaches to keep people from becoming hooked on painkillers - but real progress requires a cultural shift, for patients and doctors.

"We really have to change the way we think about the management of chronic pain - of pain in general," he said. "It requires public messaging, physician messaging. It's a big issue and it runs deep, but the consequences of not getting it right are pretty severe. It's killing us."


get more stories like this via email

United States Secretary of Health and Human Services Xavier Becerra and U.S. Rep. Yadira Caraveo - D-Thornton - recently paid a visit to Salud Family Health Centers' mobile clinic.

Each year, Salud serves up to two thousand migrant farmworkers who travel from other states and countries to plant and harvest leafy greens, corn, wheat, sugar beets, and other crops in North Central and Northeastern Colorado.

Director Deborah Salazar said her team always gets a very warm welcome.

"And it's usually the same guys that come to the same farms or greenhouses," said Salazar. "And so it's like seeing old friends. They know who we are, they know what we can do for them, and they trust us. There is trust because we have been doing this for a very long time."

In addition to its 12 brick and mortar health centers, and ten school sites, the mobile unit provides primary health services three to four evenings per week - primarily in rural areas.

They screen workers for diabetes, hypertension, cervical cancer, and anemia. Workers can also get lab tests, and flu and tetanus vaccines.

Salud is a federally qualified community health center that provides medical, dental, pharmacy, and behavioral health care services to all patients regardless of their ability to pay.

The first clinic on wheels was acquired in 1980, and Salazar said a brand new unit was rolled out in 2022.

She said her team works to build relationships with farm owners and supervisors to find the best time to plan a visit.

"If they need us to come out and start our visit on the mobile unit at 7 p.m, we can do that," said Salazar. "We are super flexible, because we don't want to interrupt their work day."

Salazar said the medical staff on the mobile unit might be the only people migrant workers see when they are not out planting and harvesting crops.

"These are the folks that put food on our table," said Salazar. "To give them quality, integrated health care - and go to them, so that they are taken care of - this is the least we can do."




get more stories like this via email

After more than 50 years of use, some Michigan lawmakers say naloxone may not be the best choice in an overdose situation.

Naloxone is sometimes called the "Lazarus drug" because of its powerful ability to seemingly resurrect people after a drug overdose.

Sen. Kevin Hertel, D-St. Clair Shores, and some of his colleagues have introduced a bill which would open the door for what they say are more costly, but more powerful, antidotes.

"Given the prevalence of fentanyl in our communities, and how much stronger some of these drugs that we're now seeing are, we believe -- and in talking with others -- that there should be other tools to respond to an overdose," Hertel explained. "To make sure we're doing everything we can to save somebody's life."

Not everyone is on board with the proposed legislation, Senate Bill 542. Opponents argued the more expensive naloxone alternatives are not necessary, and using them would only increase profits for the pharmaceutical industry.

Jonathan Stoltman, director of the Opioid Policy Institute in Grand Rapids, said while the naloxone alternatives do help in overdose situations, they can also cause nasty side effects.

"The newer approaches, they put people into more severe withdrawal," Stoltman pointed out. "That's a pretty profound negative side effect. The one approach is very inexpensive and works great; the other approach is far more expensive and has this strong negative side effect."

Sponsors of the bill say they're hoping to give Michigan residents a chance to chime in on the issue in a public hearing sometime in June. Michigan saw more than 3,000 opioid overdose deaths in 2021.


get more stories like this via email

New Mexico saw record enrollment numbers for the Affordable Care Act this year and is now setting its sights on lowering out-of-pocket costs - those not reimbursed by insurance. More than 56,000 New Mexicans are enrolled in a medical health insurance plan on the state exchange - an increase of 12,000 people overall.

Colin Baillio, deputy superintendent with the state's Office of Insurance, said the state has boosted its outreach and made efforts to improve the overall consumer experience.

"We saw a 40% year-over-year increase, and New Mexico saw the biggest percentage increase during the open-enrollment period among all of the state-based marketplaces," he explained

Part of the enrollment increase is due to what's called the "unwinding" - a federal directive that required all states to redetermine Medicaid eligibility following a three-year pause on checks during the COVID pandemic. He said by using expanded tools made available by the federal and state government, 8% of New Mexico's population is now uninsured - down from 23% in 2010.

Following approval by lawmakers in the 2024 legislative session, the New Mexico governor signed seven health care-related bills into law - one of which requires annual reporting of prescription drug pricing. Baililo said the Affordable Care Act built the foundation that has allowed the state to pursue additional affordability initiatives.

"I'm really glad to see that there's so much interest in the next step of health reform, really leaning into these out-of-pocket cost issues and making it easier for people to afford to stay covered and see their doctors," he continued.

Two years ago, the state also passed a one-of-a-kind law that did away with behavioral health co-pays for people in certain insurance plans.