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A Look at Pain and the Opioid Epidemic in Pennsylvania

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A Look at Pain and the Opioid Epidemic in Pennsylvania the OURNAL Jof the Pennsylvania Osteopathic Medical Association September 2017 A Look at Pain and the Opioid Epidemic in Pennsylvania JOIN US ON SOCIAL MEDIA! @1LECOM • LECOM.edu WELCOME TO OPPORTUNITY Earn Your Master of Science in Medical Education or Masters in Health Services Administration Degree ONLINE Take the next step in preparation for your health care career. Lake Erie College of Osteopathic Medicine developed the Master RI6FLHQFHLQ0HGLFDO(GXFDWLRQ 060HG(G FXUULFXOXPVSHFLȴFDOO\IRUFOLQLFLDQVZKRGHVLUHFDUHHUVLQDFDGHPLFPHGLFLQH DQGDFDGHPLFOHDGHUVKLS060HG(GFRXUVHVDUHGHOLYHUHGWKURXJKGLVWDQFHHGXFDWLRQGXULQJWKLVWZR\HDUSURJUDP The LECOM Masters in Health Services Administration (MHSA) program is designed to prepare exceptional leaders ready to step into administrative roles in hospitals, health care facilities, public health organizations or private practices. The MHSA SURJUDPLVFUHDWHGWRSURYLGHȵH[LELOLW\IRUEXV\ZRUNLQJSURIHVVLRQDOVORRNLQJWRHDUQWKHLU0+6$GHJUHHRQOLQHLQHLWKHU or 24 months. For more information visit LECOM.edu. College of Osteopathic Medicine • School of Pharmacy • School of Dental Medicine School of Graduate Studies • Masters/Post Baccalaureate Campuses in Erie and Greensburg, PA and Bradenton, FL THE September 2017 / Vol. 61, No. 3 ASSOCIATION OFFICERS CONTENTS President — George D. Vermeire, DO President-elect — Joan M. Grzybowski, DO, FACOFP Vice President — Pamela S.N. Goldman, DO, MHA, FACOI Secretary/Treasurer — William A. Wewer, DO, FACOFP 4 From the Editor’s Desk Immediate Past President — Anthony E. DiMarco, DO, FACOFP — Diana M. Ewert, MPA, CAE Chief Executive Officer 5 Out of My Mind EDITORIAL STAFF Editor-in-Chief — Mark B. Abraham, DO, JD 6 LECOM Dean’s Corner Editor Emeritus — Leonard H. Finkelstein, DO, FACOS Managing Editors — Diana M. Ewert and Brenda R. Dill Layout — Brenda R. Dill 7 PCOM Dean’s Corner EDITORIAL CONSULTANTS Chairman: Mark B. Abraham, DO, JD 8 A Student’s Voice — LECOM Anesthesiology: James T. Arscott DO, chairman Pain Mgmt: Harry Glass, DO; Jan T. Hendryx, DO; Christopher A. Davis, DO Acupuncture: Gregory W. Coppola, DO, Silvia M. Ferretti, DO; Jan T. Hendryx, DO 9 A Student’s Voice — PCOM Dermatology: Anthony Benedetto, DO; Richard Johnson, DO; Jana Lynn Ebbert, DO Family Practice: Marc A. Monaco, DO, chairman Geriatrics: Katherine E. Galluzzi, DO; Robert A. Weisberg, DO, co-chairmen Medicine: Joseph M.P. Zawisza, DO, chairman 10 About the Authors Alcoholism, Drug Addiction, Toxicology: Joseph M. Kosakoski, Jr., DO, chairman Allergy & Immunology: Timothy Craig, DO; James DeAngelo, DO; Timothy McCloskey, DO Cardiology: Peter F. Stracci, DO 10 Index to Advertisers Critical Care: Michael A. Venditto, DO Emergency Medicine: Gary W. Welch, DO, chairman Gastroenterology: Richard E. Moses, DO, J.D.; Glenn S. Freed, DO General Internal Medicine: Joseph M.P. Zawisza, DO; Pamela S.N. Goldman, DO 11 Guest Column Infectious Diseases: Robert S. Jones, DO; David H. Loughran, DO; Amanda E. Wehler, DO Metabolic Diseases: Jeffrey S. Freeman, DO; James E. McCann, DO; Marc A. Vengrove, DO Evaluating the Whole Person when Nephrology: Michael L. Levin, DO; Edward J. Zaloga, DO Deciding on Opioid Inclusion Neurology: Jeffrey J. Esper, DO Oncology/Hematology: John Conroy, Jr., DO; Carlin McLaughlin, DO; Jeffrey Stevens, DO Amy L. Davis, DO Pulmonary: Gilbert E. D’Alonzo, Jr., DO; Michael A. Venditto, DO Urgent Care: Mark B. Abraham, DO; Glenn R. Ortley, DO Obstetrics & Gynecology: Ralph E. Aldinger, Jr., DO, chairman 13 Guest Column Human Sexuality: Richard A. Ortoski, DO Osteopathic Principles & Practices: Alexander S. Nicholas, DO; Evan A. Nicholas, DO, co-chairmen Doctors Critical in the Fight Against Opioids Pathology: Amanda E. Wehler, DO Pediatrics: Michael E. Ryan, DO, chairman Pennsylvania Attorney General Josh Shapiro Allergy & Immunology: Timothy J. Craig, DO; Timothy J. McCloskey, DO Cardiology: Harry P. Flanagan, III, DO Neonatology: Steven M. Snyder, DO 15 CME Quiz Physiatry/Rehabilitative Medicine: Silvia M. Ferretti, DO, chairman Psychiatry: Timothy S. Mitzel, DO; Elizabeth A. Ramsey, DO Radiology: Richard M. Purse, DO, chairman Diagnostic Radiology & Nuclear Medicine: Richard M. Purse, DO Invasive Radiology: Terry N. York, DO Radiotherapy: Ellen M. O’Mara, DO; Desiree Lerro, DO Ultrasonography: David A. Levin, DO Rheumatology: Richard A. Pascucci, DO Sports Medicine: Patrick F. Leary, DO, chairman Connect with POMA on Social Media — Surgery: Theodore S. Eisenberg, DO, chairman Cardiovascular: Joseph J. Stella, DO Click on the Icons or Search for Us with Our Handles General Surgery: Theodore S. Eisenberg, DO; Steven Katz, DO Neurological: Richard B. Kanoff, DO Ophthalmology: Elena R. Farrell, DO @POMADOs Orthopedics: John J. McPhilemy, DO Otorhinolaryngology: Carol L. St. George, DO Plastic & Reconstructive: Sherman N. Leis, DO @POMA_DOs Proctology: Jerome A. Greenspan, DO Urologic: Laurence H. Belkoff, DO; George T. Zahorian, III, DO Pennsylvania Osteopathic Trauma: Susan M. Baro, DO; Jan A. Olenginski, DO; Regan P. Shabloski, DO Medical Association (POMA) The Journal of the Pennsylvania Osteopathic Medical Association (ISSN 0479-9534) is published four (4) times a year, in March, June, September and December, as the official publication of the Pennsylvania Osteopathic Medical Association, Inc., 1330 Eisenhower Boulevard, Harrisburg, PA 17111-2395. Subscription $20 per year, included in membership dues. Periodicals postage paid at Harrisburg, PA, and additional mailing offices. © 2017 by the Pennsylvania Osteopathic Medical Association. All material subject to this copyright may All original papers and other correspondence should be directed to the editor at the above address. Telephone be photocopied only for noncommercial educational or scientific uses. Permission to reprint articles or (717) 939-9318 or, toll-free in Pennsylvania, (800) 544-7662. POSTMASTER: Send address changes to The portions of articles may be obtained by writing to the managing editor. Proper credit and copyright notice Journal of the Pennsylvania Osteopathic Medical Association, 1330 Eisenhower Boulevard, Harrisburg, should accompany all reprinted material. We reserve the right to edit material submitted for clarity and PA 17111-2395. length. Opinions expressed by individuals through the pages of this magazine do not necessarily represent the official position of the Pennsylvania Osteopathic Medical Association. FROM THE EDITOR’S DESK Mark B. Abraham, DO, JD As we continue the health care debate in the ultimately spent a short time in prison as a United States, one particular conversation con- result. That physician did beat the problem tinues to stand out and grow. Whatever it is, and is now practicing successfully. When that a(n) problem, issue, concern, crisis, epidemic, physician spoke to the class, the students put (insert your own word based upon your level away laptops and such devices. There were no of concern and view of severity), it is not go- side conversations. They were all paying close ing away. As such, this issue of the Journal is attention. None were asked to do so. They real- dedicated to discussing the opioid epidemic. ized the importance of what was being taught You will read the perspectives from the to them by that doctor at that very moment. Deans of PCOM and LECOM and how they Did his story mean there would always be a are addressing the issue as their physicians not happy ending? Of course not. But, it was the Mark B. Abraham, DO, JD only treat patients in their health settings, but start of the conversation for them. Finding a Editor-in-Chief also train the next generation of physicians. way to open the dialogue is a key component Our students, the future of medicine, have to continuing to raise awareness and hope- voiced their thoughts about about treating fully, ultimately, put an end to the issue. patients with empathy and dignity, acknowl- Looking forward, our December/Winter edging that treatment is possible and we as issue will focus on the future of medicine and physicians are part of the solution. A palliative the role professional organizations, especially medicine physician shares her thoughts on POMA, will play in helping physicians and the treatment of pain and how to best help patients navigate the ever-changing world of patients suffering from chronic pain in the medicine and health care. Just as we have a current opioid-sensitive environment. As you submission this time from the Attorney Gen- may expect, there are many references in her eral and a palliative care physician, I hope piece highlighting the benefits of osteopathic that we will have other submissions from our manipulative medicine. members. I invite you to submit an article. We also have a guest submission from The If you know someone, perhaps a lawmaker, Honorable Josh Shapiro, Attorney General of person in public policy, public health or even the Commonwealth of Pennsylvania. Attorney an executive in a health-related organization, General Shapiro, whose father is an osteopath- encourage the person to write a piece. Ones ic pediatrician in Montgomery County, shares appropriate for submission will ultimately be his thoughts on how to address the issue from published. And while I cannot guarantee every multiple angles, including through involving manuscript will be printed in a specific edition, our governmental leaders, whether prosecu- it is always better to have more from which to tors, legislators or executive leaders. choose than less. The opioid epidemic is so wide reaching Similarly, even though
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