Opioid Reassessment Clinic

Preceptors: Kelcie Duesler, MSN, PMHNP-BC

The Opioid Reassessment Clinic (ORC) is an interprofessional clinic serving Bedford’s primary care clinics with the goal to of improving function, pain self-management, and opioid safety among veterans with chronic pain on long-term opioid therapy for pain who are experiencing problems related to efficacy, safety, or misuse of opioid medications. The team performs initial assessment and provides management of chronic pain, complex persistent dependence on opioids, opioid use disorder and co-occurring substance use disorders. The team consists of providers from psychiatry, pain psychology, family medicine, nursing, and peer support. The team supports a variety of learners. You will be training with family medicine residents, pain anesthesia fellows and psychology trainees and supervised by a psychiatrist and psychiatric nurse practitioner.

Opioid Reassessment Clinic Learning Objectives

• Gain proficiency with Screening, Brief Intervention and Referral to Treatment (SBIRT) model utilization in primary care clinics for SUD patients.
• Practice and model an understanding on how language can drive or reflect stigma and master using Four Principles for Language choice: 1) Respect the worth and dignity of all persons, 2) focus on the medical nature of SUD and their treatments, 3) Promote recovery process, 4) Avoid perpetuating negative stereotypes and biases.
• Identify various presentations of substance use disorders (SUD) implicated in chronic pain and chronic opioid therapy.
• Gain knowledge on interpretation and importance of DAU in SUD and Pain treatment. 
• Gain proficiency with the comprehensive evaluation and application of risk mitigation approaches for pain patients on chronic opioid therapy and the interplay of substance use and other psychiatric conditions with chronic pain.
• Learn DSM-V diagnostic criteria for substance use, somatic symptom disorder, mood and anxiety/trauma disorders in different outpatient clinical settings.
• Gain familiarity with various medically assisted therapies and psychotherapy approaches for substance use, chronic pain, mood and anxiety/trauma disorders. 
• Collaborate closely with interprofessional team members and trainees.
• Gain mastery with motivational enhancement to improve health-related behaviors including substance use and pain management.
• Summarize and identify the spectrum of aberrant medication-taking behaviors and generate a differential diagnosis.