Final Day of Addictions Nurses Conference

A much shorter day of speakers today. I am writing this on the bus returning us from Biltmore Estate where we have spent the afternoon. (The bus has wifi so hopefully I'll get this posted before returning to the hotel).

The final two sessions were presented by the same speaker.

08:40am
The Opioid Problem
Stephen Wyatt, DO, Medical Director Behavioural Health Services, Carolinas HealthCare System

Much of this session was similar to previous sessions about the seriousness and the wide spread nature of the use and abuse of opioids. While much blame has been put on physicians for over prescribing, and while much of this is also an issue, the blame needs to be shared.  The other area of blame or fault is placed at the feet of those individuals who are drug addicted. This speaker, a physician of many years, who has worked long term in various areas of medicine and osteopathy, provided us with two main issues related to The Opioid Problem. One statistic is that 55% of overdoses have resulted from family and friends sharing medication that should have been discarded.  The other issue is the nature of pain and the vicious circle of uncontrolled pain:  pain - avoidance - decreased mobility - altered functional status - diminished self efficacy - social limitations - pain. This is enhanced if opioids are over used because pain has not been accurately and effectively assessed, provided with appropriate treatments or if patient's do not understand the nature of this drug.

10:40am
Integration of Addiction Medicine in Primary Care
Stephen Wyatt, DO, Medical Director Behavioural Health Services, Carolinas HealthCare System

After a short break, Dr. Wyatt spoke about a critical change in the primary and medical care community for addictions care. That being, alcoholism and drug addiction being treated as any other chronic disease is treated. It i in fact a chronic brain disease. This would include accurate assessment, recommended treatment of a multimodal nature by the physician that include followup review and discussion of the patient's progress. Much to my pleasure he used an analogy that many of in addictions nursing have used for years:  If a patient with diabetes doesn't follow the regimen prescribed, he or she is not punished and care withheld. There is followup to determine how to help this patient.

There was one other session and I believe it was between these two. Now understand, my brain is kind of on overload, so the exact time I'm not certain. However we had an opportunity to sit with different board members to discuss different areas of the organization. I sat at the table with Stephen Strobbe, our president elect, to discuss position papers. He outlined what they are and his ideas for the upcoming year.

Then it was off to the Biltmore Estate. An amazing piece of architecture and forward thinking of George W. Vanderbilt in Asheville, North Carolina. Furniture, immense wall tapestries, a winter garden indoors,  a heated swimming pool and gymnasium. A vast library. A billiard room and bachelors quarters. An entire floor for guests. Huge kitchens and walk in refrigeration. Separate and beautifully appointed bedrooms and quarters for Mrs Vanderbilt and for any female guests (Even separate change rooms in the pool area.) This all in the early 1900's.

"There is no real ending. There's just the place where you stop the story."

~ Frank Herber