January 24, 2018 — John Russell, Steamboat Today

Nancy Beste knows about pain, and she is hoping that knowledge will be welcomed by those in Steamboat Springs who are dealing with it.

Early next month, Mountain Medical Injury & Pain Professionals will open a clinic at 320 Oak St. in downtown Steamboat Springs. Beste, a physicians assistant, serves as executive director of Mountain Medical, which started in 2009 on the Front Range.

“It began as a standard injury and pain clinic, but as we watched the opioid epidemic develop, and we saw how we had been manipulated by the pharmaceutical representatives into thinking that opioids were the answer for pain management, we kind of switched gears and started doing whole person care and started looking for opioid alternatives and helping to empower people to use healthy life skills to help manage their pain,” Beste said.

Mountain Medical headshots plus

Beste continued to work in the field of pain management even after the Medical Board in Colorado adopted new protocols that reduced the amount of opioids that were acceptable for patients and began implementing stricter standards and more oversight.

“A lot of the people in the (Denver) area that were prescribing opioids bailed out because they didn’t want to run against the current of what was acceptable according to all the standards,” Beste said. “We decided to stay the course and try to help the people who were on opioids get off, and we started to employ medicine-assisted therapy, which means switching them to other medications that will replace the use of opioids and help them to get control of their life without being on such high levels of medications.”

Beste said that the clinic’s approach to pain, both immediate and long term, is comprehensive. She understands that there are times when opioids are necessary, but the clinic focuses on helping patients determine if they have a genetic predisposition to opioid addictions, to limit all patients exposure to opioids, and whenever possible, find alternatives.

The clinic takes a holistic approach and normally starts with lab work to determine the patient’s endocrine balance and how pain and medication have affected their cortisol levels, their thyroid and their hormones.

“A lot of times just by getting them re-stabilized from a physical standpoint they are much more resilient and able to deal with their pain,” Beste said. “Then we can have them chose healthier approaches to management rather than taking pain medicine.”

Sometimes that means using medicine-assisted therapy, which is clinically driven with a focus on individualized patient care.

Drugs like buprenorphine or naloxone can help patients escape the cravings that opioids cause in the body, and under a physician’s guidance, can be used to help patients break the cycle of abuse.

The clinic is coming to Steamboat Springs as part of a SB74 grant awarded by the state of Colorado that comes from taxes generated by marijuana sales. The money will be used as part of a pilot program that will not only provide care to patients but also training for other local medical providers. The grant is administered through the nursing program at the University of Colorado’s Anschutz campus.

The clinic will train providers about how to use medication-assisted treatment to get those who are addicted off of opioids. A total of nine physician assistants and nurse practitioners in the area will be trained, and Beste is already working with Brian Siegel at the UCHealth Yampa Valley Medical Center’s Pain Management Clinic.

“Rural areas like Steamboat and Northwest Colorado are disproportionally afflicted with prescription drug addiction and at the same time we are under resourced to address this complex public health issue,” said Ken Davis of the Northwest Colorado Community Health Partnership.  “Her added services in our region will make a dramatic and meaningful impact toward tackling the treatment of this crisis and further support the provider community as an addiction specialist.

“Nobody is immune to opioid addiction and its path of wreckage in terms of damaged relationships, lost productivity, broken hearts, dysfunctional homes and rates of premature death of which we rank in the top 10 counties in Colorado,” Davis continued. “Everyone should be coming to the table and discussing our local solutions, which now fortunately include greater access to medicine-assisted therapy to treat drug addiction.”

In 2016, Routt County ranked near the top of the state with 19 opioid-related deaths, which is double the eight to 10 deaths recorded in 2014.

“People start using opioids legitimately for small injuries, and then, trying to continue functioning and raising their level to the point of where they become physiologically dependent on it,” Beste said. “I want the community to understand where that problem is and how we can avoid it, so that we can make sure that our kids and our family are able to overcome any injury or pain without having to turn to opioids.”