Medical professionals, including nurse anesthetists, are working to reduce the amount of opiates prescribed during and after surgery. THINKSTOCK PHOTO

Nurses on front lines of war against opioid addiction



ELLSWORTH — The war on heroin being waged by law enforcement has an unexpected ally: certified nurse anesthetists who are working to reduce the amount of opiates used for surgery.

“The number of overdose deaths has risen and there’s just no sign of it abating,” said Susan DeCarlo-Picirrillo, a certified nurse anesthetist who practices at Eastern Maine Medical Center and Acadia Hospital.

To that end, DeCarlo-Picirrillo and the 300-member strong Maine Association of Certified Nurse Anesthetists are hosting a fundraiser for Project HOPE called “Run for Recovery, Swing for Success” on Saturday, June 30, at the Rocky Knoll Golf Course at 14 River Road in Orrington.

Project HOPE (Heroin Opiate Prevention Effort) provides funding for treatment and recovery for those struggling with opiate addiction. The fundraiser is being done in conjunction with Healthy Acadia.

Project HOPE has been in operation at the Ellsworth Police Department and is now being offered in Washington County police departments as well. Those include Pleasant Point, Baileyville, and soon the Washington County Sheriff’s Office.

The fundraiser, “Run for Recovery, Swing for Success,” starts with 8 a.m. registration for a 5K run/walk on a trail at the golf course. Dogs on leashes are welcome. The race begins at 9.

The full-day event will feature a lunch hosted by Uno Pizzeria and Grill and golf in the afternoon. Participants may opt to participate in one event or both. There are lots of prizes for both the run and the golf tournament including a hole-in-one competition to win $25,000 cash or a new vehicle from Stanley Subaru.

To register or donate, go to http://www.meana.org/run-for-recovery-swing-for-success/.

Meanwhile, the work of the certified nurse anesthetists to do what they can to reduce opioid dependency extends into the operating room and recovery room.

Laura Schneider-Look is chief of anesthesia at Blue Hill Memorial Hospital.

“Non-narcotic anesthesia has been a big focus,” said Schneider-Look. “Blue Hill especially works hard to offer this. Our nurses are phenomenal at screening people and bringing it to my attention.”

Both certified nurse anesthetists hope to reduce the stigma associated with opiate addiction.

“We just don’t have the luxury of allowing ourselves to stigmatize that anymore,” said Schneider-Look. “It’s something that happens to your favorite niece, your friend next door, your son, people who are vulnerable and fall into a series of just the right circumstances.”

DeCarlo-Picirrillo has been in practice since 1985.

Early in her career, she rarely saw patients with opiate addictions. Now, it’s a near daily occurrence.

“I think twice now before I pick up that Fentanyl syringe for a patient,” DeCarlo-Picirrillo said.

DeCarlo-Picirrillo said she has had patients lose limbs because they’ve gotten serious infections from using dirty needles and they wait to seek treatment. One patient in her 20s eventually died after losing her leg.

To turn this around, EMMC has launched a program called “Enhanced Recovery After Surgery,” to reduce the amount of opioids used, which in turn is helping patients recover faster.

“We have found that we can greatly reduce the need for opioids,” DeCarlo-Picirrillo said. “For some cases, we don’t have to use opioids at all.”

What’s the alternative for surgeries? There are plenty.

DeCarlo-Picirrillo said magnesium infusions, lidocaine infusions, low doses of ketamine, NSAID pain relievers and intravenous Tylenol are all being used when possible to limit the amount of opioids used during and after surgery.

“We don’t want patients writhing in pain,” she said.

A “regional block” is another option.

“Whenever the surgery allows, we’ll do a regional block,” she said.

If a patient is having surgery on an arm or a foot, for example, a regional block will numb the nerves in that body part.

In Maine last year, 418 people died from drug overdoses, she said.

Fentanyl, an opioid 100 times more powerful than morphine, is resulting in many of these deaths, DeCarlo-Picirrillo said. Because Fentanyl is cheap, drug peddlers are lacing their heroin with it.

“It gives that kind of rush; they think they’re getting a better deal because it’s faster,” the nurse said.

Fentanyl “binds tightly to the receptor that controls respiration,” said DeCarlo-Picirrillo. “It means you may have to give more than one dose of Narcan to break that bind.

“They don’t realize you may have to give two. You may have to give three.”

“They’re dead and the needle is still stuck in their arm because it works so quickly,” DeCarlo-Picirrillo said. “It truly is Russian roulette. You have no idea what you’re getting.”

“We need to do more,” she said. “We need to do so much more.”

This week, the U.S. House of Representatives was scheduled to vote on HR 6, the Support for Patients and Communities Act.

The bill would allow certified nurse anesthetists to prescribe medication-assisted treatments such as methadone and Suboxone. These drugs help individuals end their addiction to opioids, Schneider-Look said.

 

Correction: An earlier version of this post misidentified the chief of anesthesia at Blue Hill Memorial Hospital. She is Laura Schneider-Look.

Jennifer Osborn

Jennifer Osborn

Reporter and columnist at The Ellsworth American
News Reporter Jennifer Osborn covers news and features on the Blue Hill Peninsula and Deer Isle-Stonington. She welcomes tips and story ideas. She also writes the Gone Shopping column. Email Jennifer with your suggestions at [email protected] or call 667-2576.