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Anesthesiologist Discusses Kentucky's Prescription Drug Abuse Issue, Pain Management

Dr. Laura Clark, a professor of anesthesia and operative medicine at the University of Louisville, presented research last week on ways to decrease dependency on pain medication and increase awareness of safer drugs at a conference in Atlanta.

Prescription drug abuse has been a problem for Kentucky, which has the third-highest drug overdose rate in the nation.

Clark recently spoke to WFPL health reporter Ja’Nel Johnson about prescription drug abuse in Kentucky and alternatives to highly addictive painkillers.

Why does Louisville have so many fish fries?

Why have the people of Kentucky been affected by prescription drug use at such a high rate?

Patients don't plan to get addicted. It's the regular every day patient. Even surgeries that you wouldn't expect still have a significant amount of pain in certain populations—for 30 to 40 percent or so—just for a gallbladder operation, breast mastectomy, those type of things. It can happen to anyone, especially those who are susceptible. And it seems that there is a regular pipeline, so to speak, in Kentucky.

How have painkillers become the drug to turn to for people?

I think the issue that I deal with specifically in my day-to-day practice is people who have under-treated pain after surgery. For the longest time all we've used is morphine and we've had the little button that everybody presses. But that's basically been the mainstay and currently still is the mainstay for treatment after surgery. But with an explosion in the science of pain management and with new techniques and new drugs, there is a much more sophisticated level of pain care out there, but it's difficult to deliver.

What are the alternatives for people who may not want to take morphine or other opiod medications? 

Multimodal or more than one type of drug or more than one type of class of drug as well as  intervention such as regional anesthesia helps to minimize the amount of morphine therefore minimize the side effects and minimize the dependence on opiods.

Are many patients aware that there are other options to manage their pain other than what the doctor automatically gives them?

They're really not aware. There's a little disconnect between bringing science to the people and actually putting it into practice. For example, insurance companies aren't quite up to speed as much as medicine innovations happen. And in hospitals these new drugs are a little more expensive, so they're wanting us to practice the old way  that's cheaper and not use these  new drugs. It's a problem with covering the cost and the health outcomes.


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