Casting wider net in opioid management

Oct. 17--HYANNISPORT -- Government and private agencies have mobilized to fight the opioid epidemic, which public health officials have called the worst drug crisis in U.S. history.

But the medical community, where the problem had its roots with overprescribing of addictive narcotics, still has a long way to go to coordinate care. That is why Patrick Kennedy, a former congressman and the youngest son of the late Sen. Edward Kennedy, says he has joined the board of directors for a for-profit startup that, among other services, provides doctors, emergency rooms and treatment centers with a complete treatment history of patients based on insurance billing records. It is more in-depth than the state's drug monitoring program, which tracks only the history of prescriptions of controlled substances.

Axial Healthcare, a Nashville-based firm, offers insurance companies and doctors in their networks information to manage patients dealing with complex pain or addiction. The company, which has not yet contracted with Massachusetts insurance providers, gives doctors tools to prevent pain patients from becoming addicted, as well as a list of addiction treatment options in the area, and an easily accessible medical history of the patients that includes addiction treatment, John Donahue, chairman and CEO of Axial, said during a panel discussion Monday at the John F. Kennedy Hyannis Museum.

As a person in long-term recovery from alcohol and opioid addiction, Kennedy explained how a service such as Axial would have helped him during his 20-year struggle with bipolar disorder, asthma and addiction.

His legislative and personal battle for decent health care, which included seven or eight admissions to residential treatment centers as well as passage of the Mental Health Parity and Addiction Equity Act of 2008, is chronicled in his memoir, "A Common Struggle."

In 2011, Kennedy left Congress after 16 years. Four months later, he injured his finger while assembling a pingpong table for his nieces and nephews, he said. At an emergency room in New Jersey, he told the nurses he was allergic to penicillin and opiates.

He called it an "allergy" so the nurses and doctors would treat his addiction as such and not give him opioid pain medicine, he said.

But after they dressed the wound, they handed him a bottle of Percocet, he said.

"My addiction dopamine receptors started really going off," Kennedy said.

His "addict brain" began to tell him how he really was in pain and needed those pills. But then his wife arrived and plucked the bottle from his hands.

"That one little wound could have killed me," Kennedy said.

Had that hospital had Axial's technology on hand, Kennedy's history of addiction treatments would have come up on his electronic medical record, Donahue said. Also, the doctors would have gotten information on medicines and treatments for pain that did not involve narcotics.

Medical school students get 100 hours of training on the treatment and diagnosis of pain, Donahue said. They get more education on how to draw blood, he added.

Dr. R. Jason Yong, an anesthesiologist and interventional pain medicine doctor at Brigham & Women's Hospital, which is using one of Axial's services, said the benefit of Axial includes getting that addiction treatment history, which otherwise is not easily available to doctors at emergency rooms or even primary care offices because of the privacy restrictions of the Health Insurance Portability and Accountability Act (HIPAA).

"There are 23 million people living in sobriety," Kennedy said. "There needs to be a greater appreciation that these medicines could kill them."

-- Follow K.C. Myers on Twitter: @kcmyerscct.

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