2017 douglas county pain summit · pdf file2017 douglas county pain summit a service of. arch...

Tuesday, March 21, 2017DANNY LANG CENTER | Umpqua Community College

2017 Douglas County P A I N S U M M I T

a s e r v i c e o f

MARCH 21, 2017 | DOUGLAS COUNTY PAIN SUMMIT

Thank you to summit sponsors and recognition of planning team.

The Douglas County Pain Summit was funded by Oregon Health Authority and Douglas Public Health Network with additional support provided by Adapt, Umpqua Health,

SouthRiver Community Health Center, CHI Mercy Health, and the Oregon Community Foundation.

This event is supported by the Oregon Health Authority Cooperative Agreement 6 NU17 CE 002751-02-01, funded by the Centers for Disease Control and Prevention. Its contents are solely the responsibility of the

authors and do not necessarily represent the official views of the Centers for Disease Control and Prevention or the Department of Health and Human Services.

We would like to extend a special thank you to: Planning – Marilyn Carter, PhD, Adapt/SouthRiver Community Health Center, Elizabeth White, MPA, Lines for Life,

Gregory Brigham, PhD, Adapt/SouthRiver/Compass, John Gardin, PhD, SouthRiver Community Health Center, Bob Dannenhoffer, MD, Douglas Public Health Network, Mark Altenhofen, MS,

Oregon Pain Advisors, Rhonda Janky, EMT, CHEC III, CHI Mercy Health and Cati Adkins, CPS, Adapt. Summit support – Mary Borges, Oregon Health Authority, Rebecca Wood, and Matt Koslowski, Lines for Life.

SPEAKERS*

Gary Allen, DMD, Vice President of Dental Services, Advantage DentalGregory Brigham, PhD, Adapt/SouthRiver/Compass

Bob Dannenhoffer, MD, Executive Director, Douglas Public Health NetworkPaul Coelho, MD, Pain Management Physician, Salem Hospital

John Gardin, PhD, Chief Behavioral Medicine and Research Officer/SouthRiver Community Health CenterLaura Heesacker, LCSW, Behavioral Health Innovation Specialist, Jackson Care Connect

Dwight Holton, CEO, Lines for LifeFiona Karbowicz, RPh, Pharmacist Consultant, Oregon Board of Pharmacy

Lisa Millet, MSH, Oregon Public Health Division, Injury and Violence Prevention Program, Oregon Health AuthorityLt. Pat Moore, Commander, Douglas County Interagency Narcotics Team

Jim Shames, MD, Medical Director, Jackson County Health and Human ServicesDave Stevens, RPh, Pharmacist, Gordon’s Pharmacy

Renée Yandel, Executive Director,HIV Alliance

*Financial Disclosure: All speakers, planners and facilitators for this event have disclosed they have no financial relationships with commercial interests.

2 | Special Thanks

DOUGLAS COUNTY PAIN SUMMIT | MARCH 21, 2017

Dear Douglas County Pain Summit Participant,

We are so pleased you could join us for this important summit!

Prescription drug abuse and misuse kills more Oregonians than any illegal drug.

Opioids are often being prescribed inappropriately and in excessive quantities with the risks far outweighing the benefits for most people. Every year, 290 million opioid pills are prescribed in Oregon – enough for 70 pills for every man, woman and child every 12 months. In Douglas County, the number of opioid prescriptions filled is consistently higher than the statewide average. (Oregon Health Authority, 2016). In sum, there are too many pills available for abuse, misuse and overdose.

The opioid epidemic demands an effective regional approach reflecting the challenges and opportunities providers, health systems and communities face across Oregon. The Douglas County Pain Summit is the sixth summit hosted by the Oregon Coalition for the Responsible Use of Meds (OrCRM). The goal of the summit is to identify the particular challenges in Douglas County and develop an Action Plan that will promote a measurable reduction in opioid abuse, misuse and overdose in the region.

The Action Plan will include strategies to:1. REDUCE THE NUMBER OF PILLS PRESCRIBED by improving health system practices for pain management2. EXPAND ACCESS TO TREATMENT SERVICES for opioid dependence and overdose prevention3. EDUCATE PATIENTS AND THE PUBLIC on the dangers, safe use and disposal of Rx4. BETTER DISPOSAL OF DISUSED PILLS in medicine cabinets that fuel abuse

The summit provides an opportunity to learn from and connect with state and local leaders. We hope you will learn, share with each other, enjoy your time and help us move from discussion to action after the summit.

Welcome | 3


7:00 - 8:00am B R E A K F A S T & R E G I S T R A T I O N

8:00 - 8:20am W E L C O M E & I N T R O D U C T I O N S Speakers: Tim Freeman, Douglas County Commissioner, Gregory Brigham, PhD, CEO,

Adapt/SouthRiver/Compass; Dwight Holton, CEO, Lines for Life

4 PLENARY: REDUCING THE NUMBER OF PILLS PRESCRIBED: PROVIDER EDUCATION, SAFE PAIN TREATMENT, PDMP

8:20 - 9:00am Oregon Pain Guidance Recommendations & Guidelines Speaker: Jim Shames, MD, Medical Director, Jackson County Health and Human Services

9:00 - 9:40am Diagnosing & Treating Working-Aged Adults with Chronic Musculoskeletal Pain Speaker: Paul Coelho, MD, Pain Management Physician, Salem Hospital

9:40 - 10:10am Oregon Prescription Drug Monitoring Program Speakers: Lisa Millet, MSH, Manager, Oregon Public Health Division, Injury and

Violence Prevention Program, Oregon Health Authority; Bob Dannenhoffer, MD, Executive Director, Douglas Public Health Network

10:10 - 10:30am B R E A K

4 MORNING SESSION - EXPAND ACCESS TO TREATMENT SERVICES: TREATMENT FOR OPIOID USE DISORDER

10:30 - 11:05am Best Practices in Medication Assisted Treatment for Opioid Use Disorder Speaker: Gregory Brigham, PhD, CEO, Adapt/SouthRiver/Compass

11:05 - 11:20am Integration of Physical and Behavioral Health Speaker: John Gardin, PhD, Chief Behavioral Medicine and Research Officer/

SouthRiver Community Health Center

11:20 - 11:50am NEXT STEPS PLANNING: Morning Session Facilitator: Dwight Holton, CEO, Lines for Life

11:50 - 1:15pm L U N C H S E R V E D A N D N E T W O R K I N G

summit agenda

4 | Summit Agenda


4 AFTERNOON SESSION - EDUCATE PATIENTS AND THE PUBLIC: DIFFICULT CONVERSATIONS WITH PATIENTS

1:15 - 2:00pm Conversation as Medicine: Compassion-Based Difficult Conversations RENT SESSIONS: AFTERNOON BREAKOUT Speaker: Laura Heesacker, LCSW, Behavioral Health Innovation Specialist,

Jackson Care Connect

2:00 - 2:20pm Responsible Opioid Prescribing: The Role of Dental Care Providers Speaker: Gary Allen, DMD, MS, Vice President of Dental Services, Advantage Dental

2:20 - 2:35pm B R E A K

4 AFTERNOON SESSION - EXPAND ACCESS TO TREATMENT SERVICES: NALOXONE FOR OVERDOSE RESCUE; BETTER DISPOSAL OF DISUSED PILLS

2:35 - 2:55pm Naloxone, DEA and Drug Take Back: Perspectives from the Oregon Board of Pharmacy

RENT SESSIONS: AFTERNOON BREAKOUTSpeaker: Fiona Karbowicz, RPh, Pharmacist Consultant, Oregon Board of Pharmacy

2:55 - 3:15pm Overdose Prevention: Pre-Hospital Administration of Naloxone Speakers: Renée Yandel, Executive Director, HIV Alliance;

Lt. Pat Moore, Commander, Douglas County Interagency Narcotics Team

3:15 - 3:35pm Preventing Abuse & Misuse: Taking Pills Out of Circulation Speaker: Lt. Pat Moore, Commander, Douglas County Interagency Narcotics Team

Safe Disposal: Pharmacies and Community Take-Back Speaker: Dave Stevens, RPh, Pharmacist, Gordon’s Pharmacy

3:35 - 3:55pm NEXT STEPS: Afternoon Session Facilitator: Dwight Holton, CEO, Lines for Life

3:55 - 4:00pm Closing Remarks Speakers: Gregory Brigham, PhD, CEO, Adapt; Dwight Holton, CEO, Lines for Life

Summit Agenda | 5


FUNCTION LOCATIONSThe Douglas County Pain Summit is being held in the main conference room on the second floor of the Danny Lang Center, Umpqua Community College. Registration is on the first floor near the main entrance. Exhibitor Tables, Lunch, Breaks and Sessions are located on the second floor.

EVALUATIONSYour feedback is very important to planning future summits and provides information and enhancements that could be made. In your folder is an evaluation form to be returned at the end of the day at the registration table.

EXHIBITSWe have a limited number of display tables with free materials on the second floor. Please take time to visit the tables and meet the organization representatives.

ACKNOWLEDGMENTS The following organizations have provided support for this activity: • Oregon Health Authority • Douglas County Public Health Network • Oregon Coalition for the Responsible Use of Meds • Adapt • SouthRiver Community Health Center • Umpqua Health • CHI Mercy Medical • Oregon Community Foundation • Umpqua Oats TARGET AUDIENCE:Physicians, physician assistants, nurse practitioners, dentists, pharmacists, behavioral health providers, nurses and other health care providers, educators, law enforcement, tribes, public health officials and prevention specialists.

LEARNING OBJECTIVESAt the conclusion of the summit, participants will: • Gain a better understanding of the problem of

prescription drug abuse statewide and regionally • Learn about current concepts, guidelines and risks of

chronic opiate therapy • Have a better understanding of the effectiveness of non-

opioid therapies to manage long-term, non-cancer pain • Learn components of a comprehensive approach to

treating patients with opioid use disorder • Understand the need to co-prescribe naloxone for

patients at high risk of opioid overdose • Have a better understanding of the importance of

safely disposing leftover medications • Understand the important role health care providers

play in turning the tide of the opioid epidemic • Incorporate learnings in clinical practice

C O N T I N U I N G E D U C A T I O N

ACCREDITATIONThis activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint providership of OHSU School of Medicine and Mercy Medical Center. The OHSU School of Medicine is accredited by the ACCME to provide continuing medical education for physicians.

CREDITOHSU School of Medicine designates this live activity for a maximum of 5.5 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

OTHER ACCREDITATIONACCBO has approved this activity for 5.5 continuing education hours.

SPEAKER PRESENTATIONS & HANDOUTSSpeaker presentations have not been printed as a waste reduction and cost savings measure. Speaker presentations and available on the OrCRM website: www.OrCRM.org.

general information

6 | general information


8:20 – 10:10 A.M.

PLENARY SESSIONREDUCING THE NUMBER OF PILLS PRESCRIBED: PROVIDER EDUCATION, SAFE PAIN TREATMENT, PDMP

This session opportunity to hear from experts in the field on ways to build heath system and community strategies for safe pain management. Speakers will present information on preventing opioid use and abuse, current best practices concerning the treatment of non-cancer chronic pain, strategies for providing compassionate care, systematic use of PDMP by providers and their delegates, improved access to non-opioid pain treatment options and ideas for solving this problem as a community. To shift away from our dependence on opioids, we must help providers be better prepared to treat patients with pain.

4 Oregon Pain Guidance Recommendations & Guidelines

Jim Shames, MD, Medical Director, Jackson County Health and Human Services

Dr. Jim Shames will discuss the history of opioid prescribing for pain and how it led to overprescribing of opioids, morbidity and mortality associated with this overuse, and data from Douglas County, Oregon and the nation in that regard. Dr. Shames will talk about Southern Oregon’s experience with collaborative workgroups as a template for this community to come together and work to create community standards for safe and effective treatment of pain. He will also discuss the impact of opioid use during pregnancy and the use of medication-assisted therapy during pregnancy.

4 Diagnosing & Treating Working-Aged Adults with Chronic Musculoskeletal Pain

Paul Coelho, MD, Pain Management Physician, Salem Hospital

Dr. Paul Coelho will discuss central sensitization and the limitations of opioids for treating non-cancer pain. He will present information on how to identify the common features of the “Central Pain” type; use the new fibromyalgia screening questionnaire; and avoid opioids in central pain syndromes.

4 Oregon Prescription Drug Monitoring Program

Lisa Millet, MSH, Manager, Oregon Public Health Division, Injury and Violence Prevention Program, Oregon Health Authority; Bob Dannenhoffer, MD, Executive Director, Douglas Public Health Network

Lisa Millet will provide information on how to access and interpret data from the Prescription Drug Monitoring Program (PDMP). The PDMP is a tool to help healthcare providers and pharmacists provide patients better care in managing their prescriptions. It contains information provided by Oregon-licensed retail pharmacies. Dr. Bob Dannenhoffer will present county level data on the impact of opioids on the community.

summit highlights

Summit Highlights | 7

OVERVIEWThe Oregon Coalition for the Responsible Use of Meds (OrCRM) and Oregon Health Authority (OHA) are working in partnership to tackle the opioid crisis through community and prescriber education, encouraging implementation of CDC prescribing guidelines, promotion of non-opioid pain management strategies, improved access to addictions treatment services and naloxone for overdose rescue and strategies for safely discarding unused medication. The complexity of this crisis requires coordinated medical, behavioral, legislative and educational policy changes. All stakeholders need to be engaged and aligned if we are to prevent future opioid dependence and support the recovery of those already dependent. OrCRM’s regional summit model is based on the concept that communities succeed when they engage all stakeholders and work together to create action plans to address opioid abuse, misuse and overdose through system level change. To effectively engage these different actors, summit sessions focus on each core element essential to reducing opioid abuse.


10:30 – 11:20 A.M.

MORNING SESSIONEXPAND ACCESS TO TREATMENT SERVICES:TREATMENT FOR OPIOID USE DISORDER

Expanding access to treatment is an essential, evidence-based strategy to reduce opioid abuse, misuse an overdose. The elements of expanded access include: offering a full range of effective and coordinated Opioid Use Disorder (OUD) treatment options, including medication and evidence-based behavioral treatment programs; coordinated medication-assisted OUD treatment with other support strategies that focus on recovery and improving cognitive, and social functioning; and increasing the number of training and education opportunities to increase the number of qualified providers. During this session, speakers will provide an overview of medication-assisted treatment for OUD, including dependence verses addiction, types of medications for OUD treatment, and the role of integrated, quality behavioral health services in improving coordinated care.

4 Best Practices in Medication-Assisted Treatment for Opioid Use Disorder

Gregory Brigham, PhD, CEO, Adapt

Dr. Brigham will provide an overview of opioid use disorder, including the distinction between dependence and addiction, review the three types of FDA approved medications for OUD, review the best practices for integrated medicated assisted treatment (MAT) and behavioral interventions and local resources. He will also discuss the importance of integration of medicines with behavioral interventions and monitoring and local resources available for treatment.

4 Integration of Physical and Behavioral Health

John Gardin, PhD Chief Behavioral Medicine and Research Officer/SouthRiver Community Health Center

Dr. John Gardin will present an expanded view of behavioral health and primary care integration that includes clinical and operational issues key to improving patient outcomes, patient satisfaction, and cost efficiencies,

focusing on patients with pain-related issues. Dr. Gardin will discuss how primary care, behavioral health and pain management interface in a Patient Centered Primary Care Home Program and integrated behavioral health as a vital part of the clinical visit.

11:20 – 11:50 A.M.

NEXT STEPS PLANNING: MORNING SESSIONFacilitator: Dwight Holton, CEO, Lines for Life

Action planning employs facilitated discussion to identify barriers and best practices and help stakeholders form core strategies for an implementation plan to increase the community’s readiness to act to reduce opioid abuse and overdose. The objective of the morning and afternoon action planning sessions are to develop a comprehensive list of action steps and identify commitments and champions that will drive implementation after the summit. For the morning session, action planning will focus on implementation of health system strategies.

1:15 – 2:20 P.M.

AFTERNOON SESSIONEDUCATE PATIENTS AND THE PUBLIC:DIFFICULT CONVERSATIONS WITH PATIENTS

It is understandable and predictable for patients to express strong feelings when presented with the need to change behavior such as reducing or eliminating prescription opioids. Pain medications can become a patient’s primary coping strategy for dealing with physical, emotional, psychological and post-traumatic pain. Delivering the change message can be triggering and even terrifying for patients and families. Strong emotions are commonly expressed and directed toward the healthcare team. Understanding effective communication strategies for compassionate refusal, tapering and other emotionally laden clinical situation will promote a positive shift in pain treatment and better health outcomes. Learning techniques to engage in these difficult conversations is also important to help educate patients and providers on the limitations of opioids for treating pain.

8 | Summit Highlights


4 Conversation as Medicine: Compassion-Based Difficult Conversations

Laura Heesacker, LCSW Behavior Health Innovation Specialist Jackson Care Connect

Laura Heesacker will talk about how to uncover some of the common traps and negotiation strategies that can trip up effective communication with patients and families. Participants will gain exposure to the behavioral underpinnings at play with people who treat people with chronic pain as well as those that live with chronic pain and encouraged to apply five guideposts to prepare for emotionally charged clinical situations. With the right mindset and tools, difficult conversations can become medicine that is safe, effective, and satisfying for patients, families and the healthcare team. Ms. Heesacker will then share real stories of those in recovery, rounding out this discussion of compassionate-based patient care. Removing the stigma around receiving assistance for opioid use disorder and approaching addiction as a treatable chronic health condition are important strategies to expanding access to effective treatment options.

REDUCING THE NUMBER OF PILLS PRESCRIBED: ROLE OF DENTAL CARE PROVIDERS

The next part of this session will continue the morning discussion on reducing the number of pills prescribed by exploring the role of dentists. Dentists are the second-highest prescribers of immediate-release opioids in the United States, often prescribing these medications in excessive quantities.

4 Responsible Opioid Prescribing: The Role of Dental Care Providers

Speaker: Gary Allen, DMD, MS Vice President of Dental Services, Advantage Dental

Dr. Gary Allen will discuss the scope of the problem and the role of dentists to decrease the opioid epidemic. Dr. Allen will provide recommendations for providers on how to manage acute dental pain though guidelines and other professional practices.

2:35 – 3:25 P.M.

AFTERNOON SESSIONEXPAND ACCESS TO TREATMENT SERVICES:NALOXONE FOR OVERDOSE RESCUE

For people who regularly take opioids, having naloxone on hand can mean the difference between life and death. The effectiveness of community and law enforcement distribution of the life-saving drug naloxone in reducing opioid overdose deaths is a proven approach. In Multnomah County, naloxone distribution through needle-exchange programs has led to a measurable decline in the number of opioid related deaths. Last summer, the HIV Alliance set up a distribution program modeled after Multnomah County now saving lives with naloxone in Lane County. Law enforcement and first responders have also been using naloxone in Oregon to save lives. New laws in Oregon are granting immunity from heroin arrests when emergency responders are summoned to the scene, which should result in an increase of emergency responses to overdoses before they become fatal. Pharmacists also play a role in expanding access to naloxone. Recently, Oregon passed new legislation that allows a pharmacist to prescribe naloxone to individuals. To prevent overdose, health systems need to incorporate strategies that eliminate barriers to co-prescribing naloxone by providers recommending opioid treatment.

4 Naloxone, DEA and Drug Take Back: Perspectives from the Oregon Board of Pharmacy

Fiona Karbowicz, RPh Pharmacist Consultant, Oregon Board of Pharmacy

Fiona Karbowicz will provide a brief perspective on pharmacist provision of naloxone, current DEA opioid manufacturing guidelines and the legalities of drug take back program. Ms. Karbowicz will provide an overview of Oregon’s 2016 HB 4124 and the Administrative Rules associated with pharmacy and pharmacist provision of naloxone, discuss the DEA’s Aggregate Production Quota (APQ) of opioid manufacturing in 2017, and highlight federal laws and state rules related to Drug Take Back initiatives.

Summit Highlights | 9

MARCH 21, 2017 | DOUGLAS COUNTY PAIN SUMMIT10 | Summit Highlights

4 Overdose Prevention: Pre-Hospital Administration of Naloxone

Renée Yandel, Executive Director, HIV Alliance; Lt. Pat Moore, Commander Douglas Interagency Narcotics Team

The objective of this presentation is to increase awareness of community-based and law enforcement strategies for reducing overdose prior to hospitalization using naloxone in Douglas County. Renée Yandel will provide information about naloxone and HIV Alliance’s Community Distribution project. She will also give an overview of Oregon specific overdose prevention legislation including a new bill allowing pharmacy distribution and the Good Samaritan law. Lt. Pat Moore will talk about efforts to encourage law enforcement and first responders to carry naloxone.

BETTER DISPOSAL OF DISUSED PILLS

Disused pills in our medicine cabinets create a significant risk for abuse and dependence -- most people who become dependent on opioids report that they first started with pills that they got from a friend or family member (NSDUH 2014). Some estimate that as many as 1/3 of the pharmaceuticals prescribed are not used – meaning that we are currently adding as many as 30 million leftover opioid pills to our medicine chests every year in Oregon alone. We can stem the flow of future dependency by establishing systems to safely and conveniently dispose of leftover prescription medications and public education.

Law enforcement was the first to recognize the need for safe and secure collection of unused medicine to prevent diversion, misuse and abuse. In Oregon, there are collection boxes in sheriff’s offices and police stations. Many local law enforcement agencies also work with communities to sponsor annual take-back events. Pharmacies across Oregon have also realized the need to implement safe and convenient collection of leftover medication. Pharmacies ranging from national chains such as Walgreens – to smaller pharmacies – like Gordon’s Pharmacy in Canyonville, as well as hospital outpatient pharmacies such as Columbia Memorial Hospital in Astoria have stepped up and installed medication collection boxes.

4 Preventing Abuse & Misuse: Taking Pills Out of Circulation

Lt. Pat Moore, Commander Douglas County Interagency Narcotics Team

4 Safe Disposal: Pharmacies and Community Take-Back

Dave Stevens, RPh Pharmacist, Gordon’s Pharmacy

Dave Stevens and Lt. Pat Moore will review procedures for increasing the safe destruction of unused prescription medication. They will discuss collection of disused medications through law enforcement and how pharmacies can become collectors of leftover medication and use community-based outreach to increase public education and awareness on the need for safe and responsible disposal.

3:25 – 4:00 P.M.

NEXT STEPS PLANNING: AFTERNOON SESSIONFacilitator: Dwight Holton, CEO, Lines for Life

4 Closing Remarks Speakers: Gregory Brigham, PhD, CEO, Adapt;

Dwight Holton, CEO, Lines for Life

The action planning discussion will focus on implementation of community strategies to tackle opioid abuse. Dwight Holton will also summarize key points addressed during the summit.


GARY ALLEN, DMD, MS, Vice President of Dental Services, Advantage Dental

Dr. Gary Allen graduated from college and dental school in Oregon and received specialty training in Oral Pathology and Oral Medicine with the U.S. Army. He retired from the Army in 1999 as a Colonel after completing a 26-year career. After returning to Oregon, he has participated as a member of several state and local committees, workgroups and commissions focusing on oral health care access, integration and quality. He is a past member of the Oregon Pain Management Commission and was selected for the Oregon Opioid Prescribing Group Task Force to develop prescribing guidelines.

GREGORY BRIGHAM, PHD, CEO, Adapt

Dr. Greg Brigham is a licensed psychologist, an APA Fellow in the Society of Addiction Psychology and, Board Certified in Clinical Psychology with 35 years of experience in behavioral healthcare. He has conducted clinical research and developed medication assisted treatments utilizing agonist, partial agonist and antagonist therapies opioid use disorder. He is an author on over 50 scholarly publications on behavioral health treatment. Dr. Brigham is currently the CEO of Adapt a provider of integrated primary care, addictions and behavioral healthcare.

PAUL COELHO, MD, Pain Management Physician, Salem Hospital

Dr. Paul Coelho worked at Kaiser Permanente in Richmond, CA for 6 years before moving to Oregon. He has 17 years of clinical experience in pain management. Dr. Coelho is a pain management physician at Salem Hospital. He is board certified and fellowship trained in PM&R and Pain Medicine. He obtained his medical degree from the University of Chicago, completed his residency in PM&R at the University of Washington, followed by a fellowship in pain management and spine care at Kaiser Permanente. His medical interests include evidence-based spine and pain management, and opioid harm reduction strategies.

BOB DANNENHOFFER, MD, Executive Director, Douglas Public Health Network

Dr. Bob Dannenhoffer is a practicing pediatrician, and serves as the county health officer for Douglas and as the executive director of the Douglas Public Health Network. He has previously served as the president of the Oregon Medical Association, as the Vice President for clinical Effectiveness at Mercy Medical Center and as the CEO of Architrave Health. Dr. Dannenhoffer has been deeply involved with patient safety.

JOHN GARDIN, PHD, Chief Behavioral Medicine and Research Officer/SouthRiver Community Health Center

With more than 40 years in behavioral health care, Dr. John Gardin possesses a unique background, blending clinical, administrative and research experiences. A recognized expert in the treatment of addictive and co-occurring disorders, as well as integrated care and behavioral healthcare management, he regularly consults with programs throughout North America and Europe, and has given countless seminars and workshops on clinical and management issues. He is currently the Chief of Behavioral Medicine at SouthRiver Community Health Center, a Federally Qualified Health Center.

LAURA HEESACKER, LCSW, Behavior Health Innovation Specialist, Jackson Care Connect

Laura Heesacker a Licensed Clinical Social Worker, has spent over 20 years working as a Behavioral Health Provider in primary care. She received her Master’s Degree in Social Work from Portland State University in 1993. Her career started by working at a Chronic Pain Rehabilitation Center as a member of a multidisciplinary team. Currently she works with Jackson Care Connect/Care Oregon as a Behavioral Health Innovation Specialist Advancing Primary Care by supporting the integration of behavioral health and helping to shift the paradigm in how we think about and therefore treat chronic pain. She is one of the founding members of the Oregon Pain Guidance group and serves as a core Steering Committee member. She is a consultant with the State of Oregon on two Opioid/Chronic Pain related grant as well as with Abt on a CDC Opioid Implementation project.

speaker biographies

Speaker Biographies | 11


DWIGHT HOLTON, CEO, Lines for Life

Dwight Holton is the Chief Executive Officer of Lines for Life, a suicide and substance abuse prevention nonprofit that promotes healthy communities through prevention, advocacy and public policy. Mr. Holton served as U.S. Attorney for Oregon in 2010-2011. He chairs the Oregon Coalition for Responsible Use of Meds (OrCRM), a task force to reduce prescription opioid abuse, misuse and overdoses. As U.S. Attorney, Mr. Holton convened the first statewide Prescription Drug Abuse Summit in the nation bringing together leaders to shed light on the epidemic of Rx abuse and build solutions. He later worked with U.S. Attorneys around the nation to convene their own Rx summits. In 2011, Oregon Health Sciences University honored Mr. Holton for his work on Rx abuse. At Lines for Life, Mr. Holton is leading expanded work in prevention of suicide and substance abuse.

FIONA KARBOWICZ, RPH, Pharmacist Consultant, Oregon Board of Pharmacy

Fiona Karbowicz has over 15 years of experience as a retail pharmacist in chain and independent pharmacies. She began work with the Oregon Board of Pharmacy in March 2011 as an Inspector and has worked as the Board’s Pharmacist Consultant since early 2014. She prepares and presents Technician and Pharmacist training courses as well as Law Review courses for Continuing Education credits and works to promote the profession of pharmacy through participation in professional organizations.

LISA MILLET, MSH, Manager, Oregon Public Health Division, Injury and Violence Prevention Program, Oregon Health Authority

Lisa Millet has a Master’s Degree in Health Science and has been the manager of Oregon’s Injury and Violence Prevention Program (IVPP) in the state Public Health Division since 1998. She spent the first ten years of her career working in behavioral health in a hospital setting before she began a 20-year career on the state and local levels in public health. Ms. Millet oversees the Oregon Prescription Drug Monitoring Programs, the Pre-hospital Emergency Medical Services data system, the Oregon Trauma Registry, the Oregon Violent Death Reporting System, basic injury and violence surveillance and epidemiology, suicide prevention, senior falls prevention, prescription drug overdose prevention and a variety of injury and violence prevention initiatives designed to reduce the burden of injury and violence in Oregon.

LIEUTENANT PAT MOORE, Commander, Douglas County Interagency Narcotics Team

Lieutenant Moore is the commander of the Douglas Interagency Narcotics Team, a multi-agency law enforcement task force. Lieutenant Moore is the former chair of Douglas County’s child abuse multi-disciplinary team, and currently serves on the board of the Mercy Foundation, whose child abuse prevention coalition he also chairs. Lieutenant Moore founded Douglas County’s opiate task force based on our county’s disproportionate number of children in foster care due to addicted parents.

JIM SHAMES, MD, Medical Director, Jackson County Health and Human Services

Dr. Jim Shames has lived and practiced in Southern Oregon since 1973. He obtained his BA from the University of Wisconsin and his MD from Hahnemann Medical School in Philadelphia. He is Board certified in Family Medicine as well as Addiction Medicine. He was the founding physician and Medical Director of the Siskiyou Community Health Center in Josephine County, and worked for La Clinica during its founding years. He has held the title of Medical Director/Health Officer for Jackson County since 2002. In response to the growing epidemic of opioid overdoses, Dr. Shames has been instrumental in the formation of Oregon Pain Guidance (OPG) which is a collaboration of health care providers in Southern Oregon that facilitate the appropriate and safe treatment of chronic pain. The OPG has created guidelines for safe prescribing as well as having created a website for both professionals and the public.

12 | Speaker Biographies


DAVID STEVENS, RPH, Pharmacist, Gordon’s Pharmacy

David Stevens received a B.S. in Pharmacy from Oregon State University in 1992, and is licensed by the Oregon Board of Pharmacy. David has over eight years of experience in corporate retail pharmacy management. David and his wife, Autumn, have owned and operated Gordon’s Pharmacy in Canyonville, Oregon, for the past sixteen years–a pharmacy with roots dating back to the 1920s. David is devoted to the practice of pharmacy and to community service, and is actively involved in local efforts to promote safe medication prescribing and disposal practices.

RENEE YANDEL, Executive Director, HIV Alliance

Renee Yandel has been with the agency since she began as a volunteer in 1999. Prior to her time as Executive Director, Renee had worked with the agency as Program Director, Housing Coordinator, Client Services Director, and Case Manager. As Program Director, Ms. Yandel oversaw: 1) the development of an innovative dental program that now provides low-cost comprehensive dental services to people living with HIV/AIDS in twenty-one counties in Oregon, 2) a groundbreaking pharmaceutical program for people living with HIV/AIDS, and 3) a Hepatitis C prevention and care program in Lane County. In this position, she was responsible for the education, prevention, and care programs which made up roughly 90% of the agency’s revenue, staff and activities. Ms. Yandel was also instrumental in expanding the agency’s care coordination and nursing case management program for people living with HIV/AIDS to ten additional counties in Oregon.

Speaker Biographies | 13

notes

MARCH 21, 2017 | DOUGLAS COUNTY PAIN SUMMIT14 | Speaker Biographies

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DOUGLAS COUNTY PAIN SUMMIT | MARCH 21, 2017 Speaker Biographies | 15

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Umpqua Community College1140 Umpqua College RoadRoseburg, OR 97470541-440-4600

Road leadsto I-5 and Highway 99

LEGENDADM Del Blanchard Welcome Center & AdministrationCC LaVerne Murphy Student CenterESB Educational Skills BuildingFFC Ford Childhood Enrichment Ctr.HNSC Bonnie Ford Health, Nursing and Science CenterJAC Jacoby AuditoriumJH Jackson HallLANG Lang Teaching, Learning & Event Center/SOWI (LANG/SOWI)LH Lockwood Hall & Finance OfficeLIB Sue Shaffer Learning Commons & Library PE PE Complex & Tom Keel Fitness Center (PE or GYM)PMO Paul Morgan Observatory RV RiverviewSCI Science BuildingSNY Snyder HallSOWI Southern Oregon Wine Institute (LANG/SOWI)SWAN Swanson AmphitheatreTC Technology CenterTOWER Tower BuildingWCH Wayne Crooch HallWFA Whipple Fine Arts CenterWHSE Warehouse

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Visitor Parking

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2017 douglas county pain summit · pdf file2017 douglas county pain summit a service of. arch...

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