The Compass Opioid Stewardship Program aims to combat the opioid epidemic through education. The program aims to accomplish the following goals: 1. Educate and provide outreach to outlier prescribers of opioids about best practices for prescribing opioids 2. Educate and provide outreach to outlier prescribers of opioids about non-opioid pain management therapies 3. Reduce the amount of opioid prescriptions prescribed by eligible prescribers
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The Compass Opioid Stewardship Clinical Cases podcast aims to provide clinicians with practical skills for managing patients on chronic opioid therapy. This 11 part podcast series introduces a framework to approaching clinical encounters with legacy patients on long term opioid therapy. Episodes highlight clinical patient scenarios through roleplaying and are followed by a discussion of the science, structure and pertinent clinical skills by Board Certified Addiction Medicine physician Dr. D ...
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The Compass Opioid Stewardship Program aims to combat the opioid epidemic through education. The program aims to accomplish the following goals: 1. Educate and provide outreach to outlier prescribers of opioids about best practices for prescribing opioids 2. Educate and provide outreach to outlier prescribers of opioids about non-opioid pain management therapies 3. Reduce the amount of opioid prescriptions prescribed by eligible prescribers
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Episode 10: Reflections on Motivational Interviewing
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In this episode, Dr. Stader calls Dr. Barnett to reflect on the philosophy of MI and how it has been transformative for his practice. Additional Learning Resources: Thomas Gordon’s Roadblocks to Communication Motivational Interviewing Workshops
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Episode 9: A Positive UA - Principles of MI in Practice
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In this episode, Dr. Stader utilizes the principles of MI when navigating an encounter with Sam, a patient who just had a routine UA test positive for fentanyl, an opioid he is not prescribed. Dr. Barnett and Dr. Stader debrief the details of this case following the encounter including the delicate position a physician occupies when establishing pa…
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Episode 8: Diet Change Talk - Principles of MI in Practice
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In this episode, Dr. Stader implements the breadth of MI tactics discussed thus far in an encounter with Peggy, a pre-diabetic patient with high cholesterol to discuss diet changes.
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Episode 7: Scaling and Eliciting Change Talk
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In this episode, Dr. Stader meets with Rebecca following a trip to the ER for a fall about the potential need to take fall risk reduction measures as she starts to age. Dr. Barnett and Dr. Stader discuss how scaling can be used to gauge where patients' readiness to implement change.
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Episode 6: Importance of Establishing Boundaries
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In this episode, Dr. Stader meet with Mark who would like to increase his opioid prescription for his back pain. Dr. Barnett and Dr. Stader discuss the importance of establishing physician-patient boundaries when discussing change behavior.
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Episode 5: Empathy, Discrepancy, Rolling with Resistance and Supporting Self-Efficacy
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In this episode, Dr. Stader conducts a new patient encounter with George. Following the encounter, Dr. Barnett and Dr. Stader talk about the four key principles of motivational interviewing: empathy, discrepancy, rolling with resistance and supporting self-efficacy in patients.
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Episode 4: Fighting the Righting Reflex
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In this episode, Dr. Stader meets with Cindy, a fibromyalgia patient on longterm opioid therapy, to discuss decreasing her percocet following a DUI. Following the encounter, Dr. Barnett and Dr. Stader discuss the importance of pushing back against the innate urge to tell a patient the solution to their problem as it can lead to resistance.…
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Episode 3: OARS Technique (Open Questioning, Affirming, Reflecting and Summarizing)
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In this episode, Dr. Stader introduces the OARS technique in an encounter with Paul who visits clinic regarding his surgeon’s wish for him to quit smoking pre-operatively. Following the encounter, Dr. Stader and Dr. Barnett dicuss how open questions, affirming patient sentiments, reflective statements and summarizing an encounter and assisting in m…
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In this episode, Dr. Stader has an appointment with Tom, a chronic pain patient grappling with a new diagnosis of sleep apnea and the need to wear a CPAP machine. Following the encounter, Dr. Stader and Dr. Barnett discuss the stages of change patients traverse.
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Episode 1: The Spirit of Motivational Interviewing
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Dr. Don Stader calls mentor Dr. Peter Barnett to vent about some feelings of burnout he is experiencing with his patients not wanting to follow directions and Dr. Barnett helps him reframe his mentality and offers up motivational interviewing as a potential strategy to employ with his patients resisting change.…
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How to Choose the Appropriate Opioid: An Interview with Dr. Heath McAnally
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Dr. Don Stader, MD, and Dr. Rachael Duncan, PharmD, sit down to chat with Dr. Heath McAnally, MD, to discuss the nuances between different opioid agents and how to choose between them to match your patient's needs. Tune in as we review the biological pain pathways and how the mu and kappa receptors are involved with different opioid agents and then…
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Mind Body Medicine's Approach to Chronic Pain: An Interview with Dr. Howard Schubiner
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Hosts Don Stader, MD and Rachael Duncan, PharmD sit down with Howard Schubiner, MD to discuss mind body medicine and the power of perception when it comes to pain. Dr. Schubiner discusses how the brain is responsible for much of the pain we experience and how we can harness this knowledge to reduce it after ruling out structural sources. Resources …
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Chronic Pain Advocacy: An Interview with Kate Nicholson, JD
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Hosts Don Stader, MD and Rachael Duncan, PharmD sit down with Kate Nicholson, JD, the founder of the nonprofit National Pain Advocacy Center whose mission is to advance the health and human rights of people in pain. Kate discusses her entry into the field of pain and her own journey developing and managing chronic pain and how she has used her expe…
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Episode 10: Putting it All Together (Chronic Pain and Opioid Use Disorders)
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Putting it all together Toolkit Opioid Prescribing and Treatment Guidance Toolkit Compass Opioid Stewardship Program Website Compass Opioid Stewardship Expert Spotlight Spotify Apple
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Episode 9: OUD Treatment: Recovery Communities and Social Adjuncts
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Addiction is about giving up everything for one thing. Recovery is about giving up one thing for everything.
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Episode 8: OUD Treatment: Medication for Opioid Use Disorder
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Buprenorphine and X Waivers Toolkit Buprenorphine Protocol Toolkit
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Episode 7: Motivational Interviewing for OUD
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Motivational Interviewing Toolkit
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Episode 6: Deprescribing - A Choice Between Tapering & Addiction Treatment
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Motivational Interviewing Toolkit
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Episode 5: Aberrancy Management in Chronic Opioid Therapy
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Risk Monitoring Toolkit Aberrancy Management Toolkit
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Episode 4: Informed Consents & Controlled Substance Agreements (CSAs)
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Informed Consent & Controlled Substance Agreement Toolkit
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Episode 3: Risk Monitoring and Mitigation for Chronic Opioid Therapy
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Risk Mitigation Toolkit
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Episode 2: Risk Screening and Stratification for OUD in Primary Care
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Opioid Therapy Risk-Assessment Screening Tools Table Recommended Screening Tools for Pain + Opioid Risk Management Toolkit A Comparison of Common Screening Methods for Predicting Aberrant Drug-Related Behavior among Patients Receiving Opioids for Chronic Pain Management
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Episode 1: An Introduction to Co-Occurring Chronic Pain & Opioid Use Disorder
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Summarized DSM-5 diagnostic categories and criteria for opioid use disorder Risks for opioid abuse and dependence among recipients of chronic opioid therapy: results from the TROUP study Rates of opioid misuse, abuse, and addiction in chronic pain: a systematic review and data synthesis
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Benzodiazepine Tapering: An Interview with Dr. Alexis Ritvo
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Host Rachael Duncan, PharmD sits down with Alexis Ritvo, MD, an assistant professor at CU Anschutz School of Medicine Department of Psychiatry and Program Director at Addiction Psychiatry Fellowship at the University of Colorado to discuss all things benzodiazepines. Tune in to learn about tapering strategies, polypharma interactions and increased …
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Opioids, Health Disparities and COVID-19: An Interview with Dr. Andrew Herring and Charles Hawthorne
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Hosts Don Stader, MD and Rachael Duncan, PharmD sit down with Andrew Herring, MD and Charles Hawthorne of CA Bridge to discuss healthy equity and disparities in the opioid epidemic. CA Bridge is a pioneering organization that expands access of evidence-based addiction care to those who use drugs across California, Andrew serves as the Director and …
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Episode 11: Putting It All Together (Opioid Stewardship)
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In this episode, Dr. Stader and Anne chat about how her pain has improved and she is getting more out of life. Following their encounter, Don and Rachael circle back on the 8 pillars of opioid stewardship tying it all together and and talk about modifying the framework to fit individual patients. Show Notes: Benzodiazepine Deprescribing Algorithm C…
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Episode 10: Cross Titration to Buprenorphine for Chronic Pain
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In this episode, Dr. Stader introduces buprenorphine as a possible agent to help manage Anne's chronic pain. Following their encounter, Don and Rachael discuss the use of buprenorphine for chronic pain and how to effectively cross titrate a patient from other opioids to the safer agent. Show Notes: Buprenorphine and X Waivers IR Opioid Cross Taper …
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Episode 9: Opioid Tapering Tips: Tapering Fentanyl & Oxycodone
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In this episode, Dr. Stader and Anne discuss how her taper is going and they agree on some adjustments. Following their encounter, Don and Rachael take a deeper dive into the specific mechanics of tapering fentanyl and Oxycodone. Show Notes: Opioid + Benzodiazepine Tapering How-To Guide Fentanyl 50 mcg TD Taper Example The Iowa Healthcare Collabora…
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Episode 8: Tapering Conversations and Benefits of Tapering / Deprescribing
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In this episode, Dr. Stader broached his concerns with Anne's medication regimen and they discuss the mechanics of tapering her off some of her medications. Following their encounter, Don and Rachael dive into the collaborative framework for a taper using the BRAVO approach. Show Notes: Optimizing Patient Communication: The Key to a Successful Tape…
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Episode 7: Respiratory Depression & Screening for Sleep Disordered Breathing
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In this episode, Dr. Stader talks with Anne about her sleep study showing sleep apnea and his concern for her medication regimen contributing to it. Following their encounter, Don and Rachael dive into the nuts and bolts of screening for sleep disordered breathing. Show Notes: 2021 BMJ Article Infographic: Diagnosing Sleep Apnea in Patients Taking …
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Episode 6: Overdose Education and Naloxone
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In this episode, Dr. Stader educates Anne about naloxone and why its appropriate in her situation. Following their encounter, Don and Rachael dive into a deeper discusison of harm reduction and how to appropriately broach the subject to patients. Show Notes: Naloxone for Patients on Chronic Opioid Therapy The Iowa Healthcare Collaborative presents …
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Episode 5: Addressing Medication Risks for Overdose
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In this episode, Dr. Stader and Anne discuss her medication list and some of their adverse side effects. Following their encounter, Don and Rachael dive into medication risks arising from opioids and certain co-prescribed medications. Show Notes: 2020 Opioid + Sedative Use in COPD Study 2017 Bzd and Z-drug Review The Iowa Healthcare Collaborative p…
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Episode 4: Reframing Pain & Introducing Pain Psychology
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In this episode, Dr. Stader meets again with Anne after reviewing her history and new pain tracking documents and starts to reframe pain to her. Following their encounter, Don and Rachael dive into the biopsychosocial approach and pain psychology. Show Notes: Behavioral Medicine for Pain: Resources for Clinicians and Patients Pain Management Algori…
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Episode 3: Opioid Stewardship Basics. CSA vs Informed Consent. How to Best Track Function, Risk Stratify and Screen Patients on COT
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In this episode, Don and Rachaeldiscuss informed consent and what tools to use for risk stratification and monitoring. Informed Consent and Controlled Substance Agreements Screening Tools for Pain and Opioid Risk Management Risk Management: Putting it All Together The Iowa Healthcare Collaborative presents the Compass Opioid Stewardship Clinical Ca…
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Episode 2: Building Therapeutic Alliance and Introducing an Opioid Stewardship Framework
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In this episode, Dr. Stader gets to know Anne better and introduces his principles of opioid stewardship to her and how it will look. Following their encounter, Don and Rachael discuss the importance of therapetutic alliance and using evidence-based tools to track her treatment and pain. Show Notes: Compass Opioid Prescribing + Treatment Guidance T…
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Episode 1: Assuming Care for a New Patient on Chronic Opioid Therapy (COT): Meeting a Patient’s and Society’s Needs
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In this episode, Dr. Stader meets Anne, a chronic pain patient new to his practice and they review her medical history. Following their encounter, Don and Rachael discuss the lack of longterm efficacy of opioids for pain management and their safety risks. Show Notes: Opioid Risks and Side Effects The Iowa Healthcare Collaborative presents the Compa…
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NIDA Policy Issues: An Interview with Dr. Emily Einstein
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Hosts Dr. Don Stader and Dr. Rachael Duncan, PharmD sit down with Dr. Emily Einstein, PhD, chief of the Science Policy Branch for the National Institute on Drug Abuse (NIDA). This episode ranges from policy issues at NIDA and plans to implement actionable interventions to improve care for those suffering from addiction to in-depth biology of addict…
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Pain, Opioids and Sleep: An Interview With Dr. Heather Poupore-King
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Hosts Dr. Don Stader and Dr. Rachael Duncan, PharmD sit down with Stanford pain psychologist Dr. Heather Poupore-King, PhD to discuss the intersection of pain, opioids and sleep. This episode addresses the biopsychosocial approach to health and highlights how relevant it to how pain and opioids affect your sleep and how sleep quality and quantity c…
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NIH HEAL Initiative: An Interview with Dr. Rebecca Baker
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Hosts Dr. Don Stader and Dr. Rachael Duncan, PharmD sit down with Director of the NIH's Helping End Addiction Longterm (HEAL) Initiative, Dr. Rebecca Baker, Ph.D. In the podcast we discuss the opioid crisis, health disparities and scope of HEAL Initiative. Dr. Baker shares her insights into how the NIH has prioritized efforts to better understand a…
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Learning to Champion Chronic Pain: An Interview with Tom Bowen
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Hosts Dr. Don Stader and Dr. Rachael Duncan, PharmD sit down with Tom Bowen to discuss his personal journey through dealing with chronic pain. Tune in to hear Tom's story and how he learned to live with his chronic pain by changing his perspective and utilizing invaluable self-directed pain management techniques. Tom is an active advocate for patie…
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Nuts & Bolts of OUD in the Primary Care Setting
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Dr. Steven Wright joins us to explain how to best manage patients with OUD in the primary care setting. Tune in to learn how to counsel patients with OUD and responsibly incorporate buprenorphine, naltrexone and methadone into your practice in this eighth installment of the Compass Opioid Stewardship Program lecture series. Feel free to contact Dr.…
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A Patient and Bioethicist Perspective on the Medical System's Role and Responsibilities in the Opioid Crisis: An Interview with Dr. Travis N. Rieder, PhD
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Hosts Dr. Don Stader and Dr. Rachael Duncan, PharmD sit down with Dr. Travis Rieder, PhD, a Research Scholar at Johns Hopkins Berman Institute of Bioethics to discuss his personal experience becoming dependent on opioids following a traumatic motorcycle accident and navigating the healthcare system to wean himself from his medications. Iowa Healthc…
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Recognition and Management of Opioid Use Disorder (OUD): An Interview with Dr. Corey Waller
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Hosts Dr. Don Stader and Dr. Rachael Duncan, PharmD sit down with Addiction and Emergency Medicine physician Dr. Corey Waller to define addiction, discuss strategies for recognizing signs of OUD early and then appropriately manage it. Iowa Healthcare Collaborative presents the Compass Opioid Stewardship Expert Spotlight podcast in partnership with …
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Recognition & Management of Patients with OUD
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Dr. Don Stader joins us to explain how to identify OUD in patients on short-term and long-term opioid prescriptions and discuss the benefits of medication assisted treatment for addiction. Tune in to learn how to incorporate buprenorphine into your practice in this seventh installment of the Compass Opioid Stewardship Program lecture series. Feel f…
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Chronic Pain Management: Best practices.
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Dr. Steven Wright joins us to explain the best practices for chronic pain management in this sixth installment of the Compass Opioid Stewardship Program lecture series. Feel free to contact Dr. Stader at don@staderopioidconsultants.com with any questions or inquiries. Iowa Healthcare Collaborative presents the Compass Opioid Stewardship Program Pod…
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Pain Psychology: An Interview with Dr. Heather Poupore-King
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Hosts Dr. Don Stader and Dr. Rachael Duncan, PharmD sit down with Stanford pain psychologist Dr. Heather Poupore-King, PhD to discuss the nuance of pain psychology and management of patients with chronic pain. Iowa Healthcare Collaborative presents the Compass Opioid Stewardship Expert Spotlight podcast in partnership with the Centers for Medicare …
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Opioid Tapering: An Interview with Dr. Anna Lembke
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Hosts Dr. Don Stader and Dr. Rachael Duncan, PharmD sit down with Dr. Anna Lembke to discuss her BRAVO protocol for opioid tapering. Iowa Healthcare Collaborative presents the Compass Opioid Stewardship Expert Spotlight podcast in partnership with the Centers for Medicare and Medicaid Services. Visit their website for more information on the Compas…
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Opioid & Benzodiazepine Tapering - Best Practices
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Dr. Don Stader and Dr. Steven Wright explain the best practices for opioid and benzodiazepine tapering in this fifth installment of the Compass Opioid Stewardship Program lecture series. Feel free to contact Dr. Stader at don@staderopioidconsultants.com with any questions or inquiries. Iowa Healthcare Collaborative presents the Compass Opioid Stewa…
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Physiology of Pain: An Interview with Dr. Heath McAnally
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Hosts Dr. Don Stader and Dr. Mary Andrawis, PharmD sit down with Dr. Heath McAnally and dive deep into the weeds of pain physiology, opioid induced hyperalgesia and so much more. Iowa Healthcare Collaborative presents the Compass Opioid Stewardship Expert Spotlight podcast in partnership with the Centers for Medicare and Medicaid Services. Visit th…
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Opioid MedMal and Litigation Risks: An Interview with Mr. Harry Nelson
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Hosts Dr. Don Stader and Dr. Mary Andrawis, PharmD sit down to discuss the intricacies of litigation risks that come with prescribing opioids with healthcare attorney, Mr. Harry Nelson. Tune in to review the risks and practices you can adopt to protect yourself as a prescriber. Iowa Healthcare Collaborative presents the Compass Opioid Stewardship E…
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