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Reducing Kids’ Access to Opioids

By the end of the day, nearly 100 more Americans will die from an opioid overdose. It’s a dire situation that The National Institute on Drug Abuse calls a devastating public health crisis.

But it’s not just adults who are falling victim. It might surprise you to know that every day in the United States, 2,500 kids ages 12 to 17 try a prescription pain reliever for the first time. They are perpetuating the cycle of abuse and running the risk of soon becoming yet another statistic in this tragic epidemic.

If we’re going to end this scourge, we must take a two-pronged approach: We must not only work harder to educate adults about the dangers of opioids and limit their availability, but we must also implement strategies to protect the next generation from ever becoming addicted. That will require collaboration between hospitals, outpatient clinics and the community.

Many people who end up addicted to opioids initially get the drugs from hospitals and medical providers, and that includes children. Acute and chronic pain management has become a major part of pediatric medicine. It is important to remember, however, that pediatric pain medicine is very different than adult pain medicine.

[See: 8 Questions to Ask Your Pharmacist.]

When an adult visits a pain doctor, for example, it is typically for a procedure. The patient may have low back pain and therefore receive an injection directly to the site of pain, which usually has a combination of numbing medicine as well as steroid to decrease inflammation. This interaction is very appropriate under the circumstance.

However, pediatric pain usually encompasses not only the patient, but everything that surrounds him or her. This may include family, friends, school and work — what we call the psychosocial context. Pain is so complex in children that many things can affect or worsen it and, vice versa, pain can make many things in a child’s life much worse.

In an effort to control pain and limit addiction, Nationwide Children’s Hospital became one of the first institutions in the world to have a designated Comprehensive Pain Services. The comprehensive approach best serves our patients pain management optimally and allows us to seamlessly transition patients between different areas of the hospital and phases of treatment.

Here, interventions like injections and opioid medications are extreme last resorts in the diagnosis and management of a pediatric pain and are not the standard of care.

In the past, for example, if a child were to undergo surgery, he or she might be hospitalized for several days following surgery and given systemic pain medication to control pain during recovery. But we have pioneered innovative pain-blocking techniques that use ultrasound machines and tiny catheters to direct pain medication only to the nerves affected during and after surgery.

The technique eliminates the need for opioids and, in a recent study of knee surgery cases at Nationwide Children’s Hospital, reduced admissions by 98 percent.

[See: 4 Opioid Drugs Parents Should Have on Their Radar.]

Our inpatient teams of practitioners perform approximately 200 nerve blocks per month to help minimize surgical-related pain. They also employ techniques such as biofeedback, aromatherapy and acupuncture.

Once a child is dismissed from the hospital, our outpatient Pain Clinics take a team approach to the long-term management of their pain. Physicians, psychologists, nurses, massage therapists, acupuncturists and social workers all team up to address as many aspects of a child’s life as possible, to help him or her manage pain and heal as quickly as possible.

We are also working with community leaders on an Opioid Safety Task Force to address the issue of addiction beyond hospital walls. We are defining best practices for opioid safe prescribing guidelines for pediatric practitioners, including limiting overprescribing of medications, especially unnecessary opioids.

We are also providing and encouraging the usage of lockboxes to many of our patients who have prescription pain medications at home. A recent study found that 2 out of 3 adults who have young children in the home admitted that they do not take the necessary steps to store pain medications safely. That means a child’s first encounter with abusing opioids may be less likely the result of getting them from a street dealer as it is simply taking them from the medicine cabinet at home.

The paradigm of pediatric pain medicine is continuing to evolve and shift. If we are going to break this tragic cycle of opioid abuse, addiction and death in this country, it is imperative that acknowledge the threat it poses to our children and employ comprehensive approaches to save them from this epidemic.

More from U.S. News

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Reducing Kids’ Access to Opioids originally appeared on usnews.com

Don’t Settle for Student Loans to Pay for Online Education

Online college programs are becoming a more popular choice for prospective students, with one study finding that more than 6 million students enrolled in at least one online course in fall 2015. The popularity of these courses can be attributed in part to their flexibility with working adults' schedules, students' ability to progress more quickly through online programs and, oftentimes, cheaper tuition. [See 10 low-cost online bachelor's programs for out-of-state students.]Online degrees can be beneficial to many college students, but some studies have shown online learners complete their programs at lower rates than students at traditional brick-and-mortar campuses. Individuals with student loans but no degree comprise two-thirds of defaulted borrowers. Though these numbers are not encouraging, just like for traditional programs, there are ways to reduce how much you'll need to borrow for an online program to ensure you won't become one of these statistics. Don't just settle on borrowing student loans to cover the whole cost of your program and living expenses. Instead, start thinking about how to cut costs and cover your balance in different ways, such as the following. -- Grants and scholarships: Even though you are taking an online course, you can still apply and receive grants and scholarships. But your first step should be to complete the Free Application for Federal Student Aid, commonly referred to as the FAFSA, which will allow you to receive a Pell Grant if your expected family contribution is low enough. The EFC criteria and award amounts are adjusted annually, but the 2017-2018 academic year awards range from $606 to $5,920, which could significantly lower the amount you borrow annually. Your next step is to apply for scholarships. You can start by checking online scholarship search engines, such as the Salt Scholarship Search, College Board's BigFuture and Peterson's. But don't forget to take advantage of local organizations and your school's financial aid office. Both may offer scholarships that you can't find with a national scholarship search. [Review these 10 sites to kick off your scholarship search.]For instance, organizations like the Elks Club, Knights of Columbus or the Rotary Club typically offer scholarships annually to local students. Just because you're going to school online doesn't mean you're ineligible. Visit your local library for scholarship listings, and ask around town. You might be surprised how many local organizations offer scholarships. While these scholarships typically aren't large, every little bit counts. Each dollar you receive in a scholarship is a dollar you don't have to borrow and pay interest on. -- Work-study: Another option for online students may be work-study awards. Not all students enrolled in online programs are eligible, but students at some schools -- including, for example, SUNY Empire State College and Liberty University -- are. Work-study awards are not given upfront like scholarships and grants. In most cases, they are an offer to earn up to the awarded amount if you secure an eligible work-study job. While there is a misconception that all work-study jobs must be on campus, students can work for off-campus, nonprofit or public employers as long as the work is in the public's interest. You may be able to work for a for-profit employer if the job is relevant to your course of study. No matter who the outside employer is, it will need to have an established agreement with your college for you to receive work-study funds. Remember, to be eligible for federal financial aid, you must be enrolled and pursuing a degree or certificate. If you're not working toward a credential, Pell Grants and work-study won't be option, but you may still be able to take advantage of private scholarships -- just be sure to read the eligibility criteria carefully. [Explore what to know about financial aid in online programs.]-- Pay as you go: One of the great benefits to enrolling online is the flexible schedule, which can allow you to complete your college coursework around your responsibilities. But prospective students often overlook using their part- or full-time job earnings as an option for paying for college. Almost 80 percent of college students in 2015 worked at least part time while attending classes, according to the National Center for Education Statistics. By budgeting and thinking strategically about your college costs, you can likely reduce your dependence on student loans by paying a portion out of pocket. Many -- but not all -- online programs are less expensive than traditional programs and often have shorter payment periods. Six, eight or 10 weeks are common course durations. Because of the frequency of payments in an online setting, you may be well-placed to pay as you go and possibly avoid borrowing altogether. Attending college online and avoiding student loans may be challenging, but if you are willing to put in the effort, you can limit the amount you need to borrow. More from U.S. News Q&A: Understanding Student Loan Discharge Eligibility Student Loan Refinancing Isn't Right for All Borrowers
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