SHERIDAN — The Wyoming Department of Health-Behavioral Health Division funded a training program through Recover Wyoming to share emerging best practices in behavioral health care and opioid recovery and response.

Lynn Carlson, Recover Wyoming volunteer and facilitator, shared “Road Trip to Recovery: Shared Decision Making” at the Best-Western Sheridan Center Tuesday. Carlson said SDM is a collaborative approach to health care that places the patient/client and provider on equal ground.

Laura Griffith, founder of Recover Wyoming, shared “Opioids in Wyoming, Medication Assisted Treatment and Opioid Overdose Reversal.”

Recover Wyoming is the only federally-recognized recovery community organization in Wyoming and is peer-led, peer-driven and peer-managed, meaning every employee is in recovery, Griffith said.

Griffith and Carlson presented the trainings in six other cities in Wyoming where turnout was better than in Sheridan, Griffith said. Their main goals are to reduce stigma surrounding behavioral and mental health conditions, generate awareness and provide tools for recovery, Carlson said.

“Recovery is possible…it’s right next door,” Griffith said. One of the ways Griffith pursues the Recover Wyoming mission is by talking about her own journey through recovery from alcoholism openly and honestly, she said.

“How can people know it’s possible if no one is talking about it?” Carlson said.

Griffith said about 23.5 million adults have reported that they are in recovery for drug or alcohol addiction in the U.S.

Opioid use disorder in Wyoming

Unlike many states across the nation, opioid use disorder is not a crisis in Wyoming, Griffith said. Alcohol and methamphetamine abuse are bigger issues, she said.

Still, Griffith’s training detailed best practices for responding to an opioid use disorder including administering Narcan in the case of an overdose and medication-assisted treatment for recovery.

The Wyoming Statistical and Analysis Center said in a 2017 study that the rate of non-prescribed use of prescription pain medication is about 3% in Wyoming, comparable to the national average, 4%. However, Wyoming’s prescribing rate for opioids is slightly above the national average, the study said.

Opioid overdose deaths have increased in Wyoming over time, but have a stable rate of increase compared to the rest of the country. Griffith said the low number of reported deaths in Wyoming may be attributed to a “small town stigma;” a coroner may indicate a person died from a heart attack instead of a drug overdose to protect their family.

Griffith said Wyoming is one of the states in the U.S. addressing over-prescription of opioids effectively, citing the 2004 Prescription Drug Monitoring Program and federal funding that supports medication-assisted treatment.

Griffith and Carlson said they were disappointed that former Casper Dr. Shakeel Kahn received the minimum possible sentence for his role in distributing oxycodone and other drugs across multiple states.

Kahn was sentenced Aug. 12 to 25 years imprisonment, three years probation after his release and $5,000 in restitution to the family of one woman who died as a result of Kahn’s drug distribution ring.

Barriers to medication-assisted treatment in Wyoming include limited space in recovery institutions, lack of available clinicians and cost, Griffith said. She said funding for MAT helps alleviate some of the expense to patients.

While MATs have a low risk of overdose and are considered safe and effective, opioid users have told Griffith they can absolutely be misused, she said.

Griffith compared using MATs for opioid use disorder to using insulin for diabetes —  treating a medical condition with the appropriate medication and dosage can be highly effective, she said.

Shared decision-making method

Carlson said SDM is designed to give patients the confidence to make decisions about what health care decisions are best for them, their families and their lifestyle.

SDM helps patients become better informed, invested and more likely to follow through with effective treatments, Carlson said Tuesday.

A Cochrane Systematic Review of Decision Aids found that SDM improved knowledge, understanding and confidence in making decisions about health conditions and helped people develop realistic expectations about their treatment, according to materials provided at the training.

While some providers have expressed concerns that the method is time consuming, some advocates and researchers argue it saves time in the long run by developing successful, long-term treatments, Carlson said.

She said it can be powerful when nonjudgmental people create a safe space for others to share their questions, concerns and treatment goals.

“All I did was listen,” she said. “That’s a big part of the magic of it.”

One of the components of the SDM approach is providing decision aids, tools and resources that help isolate a patient’s goals and priorities, Carlson said.

Decision aids “can be used by health providers, peers, recovery coaches, family members and friends to help individuals make informed and thought-through decisions,” according to materials provided at the training.

Decision aids, medication-assisted treatment and shared decision-making are tools that can help successfully treat many addiction disorders, Griffith said.

According to materials from the training, these events were designed to educate therapists, job coaches, care managers, physicians, nurses and other providers about emerging best practices in behavioral and mental health care.

Resources and online trainings about addiction disorders and recovery are available at recoverwyoming.org