KELLY MCEVERS, HOST:
The opioid epidemic has forced doctors throughout the country to rethink how they treat pain. In Colorado, a major health care provider is trying to teach patients about alternative treatments, hoping they will stay away from addictive pills. Colorado Public Radio's John Daley reports.
JOHN DALEY, BYLINE: Robert Kerley makes his living as a truck driver, but seven years ago, he was loading drywall when a gust of wind knocked him off the trailer. Kerley fell 14 feet and hurt his back. Doctors prescribed a variety of opioids - Vicodin, Percocet, Oxycontin.
ROBERT KERLEY: I spent most of my time high, laying on the couch, not doing nothing, sleeping, dozing off, falling asleep everywhere.
DALEY: In less than a year, the 45-year-old says he was hooked. He lost weight. He lost his job. His relationships with his wife and kids struggled. Kerley remembers when he hit rock bottom. He had three beers and...
KERLEY: I was taking so much morphine that I respiratory arrested because of it. I stopped breathing.
DALEY: EMTs gave him the overdose reversal drug naloxone. As the father of a 12-year-old son, he knew he needed to turn things around.
KERLEY: After seven years of being on narcotics and in a spiral downhill, the only thing that pulled me out of it was going to this class, working the program that they ask you to work.
DALEY: That program as Kaiser Permanente Colorado's Integrated Pain Service. It's an eight-week course that costs patients $100. Will Gersch teaches high-risk opioid patients about pain management.
WILL GERSCH: These two numbers - 50 and 100 - if you're over these two doses, that's a risk factor.
DALEY: Today's topic - the science behind prescription drugs.
GERSCH: The overarching message here is like, the higher the dose of the opioids, the higher the risk.
DALEY: Upstairs, his colleague Amanda Bye, a clinical psychologist, highlights a key element of the program - it's integrated.
AMANDA BYE: We brought in all these specialists. We all know the up-to-date research of what's most effective in helping to manage pain. And that's how the program got started.
DALEY: For patient care, there's a doctor, a clinical pharmacist, two mental-health therapists, a physical therapist and a nurse all on one floor so patients can meet with this team instead of dealing with a series of referrals. Kaiser tracked more than 80 patients over the course of a year. It found the group's ER visits decreased 25 percent. Inpatient admissions dropped 40 percent, and patients' opioid use went way down.
BYE: We've had really good results getting those patients unstuck from the mud, getting them moving and living the life they want to live.
DALEY: Bye says the team helps patients use alternatives like exercise, meditation, acupuncture and mindfulness, though some patients do need to go to the chemical dependency unit for medication-assisted treatment. Benjamin Miller is an expert on integrated care with the national foundation Well Being Trust. He says Kaiser is on the right track.
BENJAMIN MILLER: The future of health care is integrated. And unfortunately, our history is very fragmented. And we're just now catching up to developing a system of care that meets the needs of people.
DALEY: Similar programs in California showed a reduction in the number of prescriptions and pills per patient says Kelly Pfeifer with the California Health Care Foundation.
KELLY PFEIFER: We've seen great success with these models that are integrating complementary therapy, physical therapy, behavioral health and medical care.
DALEY: She says one challenge is scale - Big systems are the ones that can afford programs like this - another is insurance payment.
PFEIFER: Frequently, behavioral health and medical health are paid for by entirely different systems.
DALEY: And some insurers won't pay for the kinds of alternative treatments that have really helped Robert Kerley. He now starts his morning with stretching and a version of tai chi. His advice to others suffering from pain or addiction?
KERLEY: Do whatever it takes to walk away from it, like, no matter what. Trust me. It gets better. It gets 100 percent better than where you're at right now.
DALEY: Better for Kerley means he's back at work, once again able to make a living as a truck driver. For NPR News, I'm John Daley.
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