LITTLE ROCK — A $1.5 million grant from the U.S. Substance Abuse and Mental Health Services Administration (SAMHSA) will allow the University of Arkansas for Medical Sciences (UAMS) Department of Emergency Medicine to revolutionize the ways in which it treats pain and trains new doctors.
The award funds a three-year project to train UAMS emergency physicians, advanced practice providers and nurses about pain management strategies that treat pain aggressively but don’t rely on opioid medications.
Michael Wilson, M.D., Ph.D., an associate professor in the UAMS College of Medicine departments of Emergency Medicine and Psychiatry, said he expects the project to lead to better pain management throughout Arkansas.
“We believe that training providers on how to treat pain more effectively, but without using opioids, will not only help current UAMS patients, but will also help the rest of the state for years to come,” Wilson said.
Wilson is the co-primary investigator with Carly Eastin, M.D., an associate professor in the UAMS Departments of Emergency Medicine and Pediatrics, who added, “This is because approximately 45% of UAMS emergency medicine residents remain in Arkansas after graduation, and the majority of emergency department physicians currently working in Arkansas were trained at UAMS.”
The project is called “Improving Emergency Department Management of Acute and Chronic Pain Using Non-Opioid Strategies.”
“We are also hopeful,” Wilson said, “that the UAMS Department of Emergency Medicine can serve as a statewide model for successful pain management without opioids, since Arkansas has had the second-highest opioid prescribing rate in the nation since the early 2010s.”
In 2016, Arkansas physicians prescribed 114.6 opioid prescriptions for every 100 people. While the number declined to 75.8 prescriptions for every 100 people by 2020, the rate remains 75% higher than the national average of 43.3 prescriptions for every 100 people, he said.
The project aims to improve pain relief but reduce the use of opioids through three initiatives: provider education and electronic medical record optimization, using peer navigators to help patients manage pain without opioids and, for patients whose use of opioids is either ineffective or hazardous, implementing interventional pain procedures such as acupuncture and nerve blocks.
“The impact of these initiatives will be profound,” Wilson predicted. “We estimate that we will be able to affect care for more than 8,000 patients each year who come to the emergency department with painful conditions. We hope the program will become a statewide model for aggressive pain management without opioids.”
UAMS is the state’s only academic medical center and has the largest residency training program in emergency medicine, which serves more than 65,000 patients annually. On average, 11,000 patients each year come to the UAMS emergency department complaining of pain.
A predominantly rural state, Arkansas has the sixth-highest poverty rate in the nation, and many patients have poor access to treatment providers and facilities. It ranks among the top 10% of states whose patients need treatment for opioid use disorder.
