Find out how local pediatricians are addressing opioid epidemic

On a recent Saturday morning, a group of pediatricians and health professionals gathered in a resort conference room to learn how to screen young patients for drug abuse.

It was a first for many of them.

“Nobody taught us how to do this,” said Dr. Odett Stanely-Brown, a pediatrician in Clermont. “We know how to talk to patients but not specifically about drugs. It’s not something we know how to do it very well.”

During the meeting, doctors learned about a technique called motivational interviewing, where instead of telling the patients what to do and what not to do, they try to motivate them to make positive decisions and establish goals.

They also heard about opioid-free surgery, drug testing and prescribing guidelines based on Florida’s new opioid law.

“The laws are changing all the time. The drugs are changing all the time. I learned a lot. You gotta keep up,” said Dr. Susan O’Toole-Evans, a pediatrician in Vero Beach.

Children and adolescents make a small portion of victims of the opioid epidemic, but experts say identifying early signs of substance abuse — whether it’s alcohol, marijuana or opioids — is important because the adolescent brain is still growing, making teens more vulnerable to addiction.

In 2016, 3.6 percent of adolescents aged 12 to 17 reported misusing opioids, according to federal data. This percentage is twice as high among older adolescents and young adults aged 18 to 25. And the vast majority of this misuse is due to prescription opioids, not heroin.

There’s some good news. Prescription opioid misuse among high school seniors has been decreasing, partly because many pill mills have been shut down and it’s harder to get them. Yet, the rate of drug overdose deaths among adolescents is increasing, research shows.

“Most adults [with addiction] started when they were teens,” said Dr. Annabella Torres, a general pediatrician and coordinator of adolescent pediatrics residency at Orlando Health. “They think they’re invincible. And a lot of times they don’t listen to their mom, but they may listen to me or a resident.”

The idea of such a conference had been percolating for a while as one of the Orange County Heroin Task Force’s recommendations. The group formed in August 2015.

Then last year Dr. Lloyd Werk, division chief of general academic pediatrics at Nemours Children’s Hospital, got a call from David Siegel.

Siegel is the CEO of Westgate Resorts and, since losing his daughter to a toxic mix of prescription medications in 2016, he’s been a vocal advocate of curbing the epidemic. Siegel told Werk that he wanted to bring together local leaders to discuss adolescent substance abuse and have a meeting at one of his resorts, Werk recalled.

“A good first step was to convene a conference that would focus on screening and prevention of substance abuse and teach doctors and health care professionals proper opioids prescription,” said Werk.

The result was the recent conference that brought together more than 100 pediatricians and health professionals with the help of the hospital, Orange County Medical Society and other local health institutions.

To teach doctors new interviewing techniques, Dr. Tom Hall, associate director of medical health administration student health services at the University of Central Florida, organized mock patient interviews.

He brought in students from UCF’s theatre department to play the role of patients. Faculty from UCF’s doctoral psychology department demonstrated how to do the interviews.

Attendees also received a 20-page toolkit that outlined drug screening tools and a list of resources in the community.

“The toolkit provides them with the reasoning behind, the screening questions and then with any result of the screening, what do you do next?” Werk said.

National groups like the American Academy of Pediatrics and agencies like Substance Abuse and Mental Health Services Administration have recommendations for opioid abuse screening in youth, but there’s evidence that providing pediatricians with educational materials like the toolkit developed here improves their knowledge and ability to screen patients.

In Massachusetts, where a toolkit similar to the one developed by local leaders here is mailed to pediatricians, the majority say they know how to screen adolescents for substance abuse, said Dr. Sharon Levy, director of adolescent substance use and addiction program at Boston Children’s Hospital.

“In terms of getting the idea that substance abuse needs to be incorporated in pediatrics, in Massachusetts we are there. Pediatricians in Massachusetts are convinced that this is an important part of primary care,” said Levy, associate professor of pediatrics at Harvard Medical School.

The local conference didn’t reach all Central Florida pediatricians.

“This is just one step,” Werk said.

The group has launched a six-month study at several pediatric practices that are committing to integrate discussion about drugs into their practice.

“I’m hoping that one of the products of this program will be that we’ll be able to share what we did at a national forum,” he added.​

nmiller@orlandosentinel.com, 321-436-9205, Twitter; Instagram; Facebook; LinkedIn.