opas1

Monday

Welcome to OPAS


Dr. Rotchford's approaches are "cutting edge 

for addressing problematic opioid use in high-risk patients."

Alex Cahana, M.D., Professor and Chief, Division of Pain Medicine,
University of Washington Medical Center

Olympas Pain and Addiction Services (OPAS) at OPAS.us is a medical clinic in Port Townsend, WA founded by James K. Rotchford, M.D. for patients seeking specialized treatment for pain and substance abuse disorders.

Publications written by or recommended by Dr. Rotchford
  • OPAS Handouts - links to more than 120 helpful publications.
  • Opidemic.help - "State of the Disease" from a Public Health perspective.
APPs - best if viewed on a smartphone
Other Information
  • OpioidDocs.com - helpful links to related associations, publications, and videos.
The tabs at the top of the page will provide you with ample resources and help for you to become an established patient.




Saturday

Videos

Videos by Dr. Rotchford

Click on image to visit Dr. Rotchford's Playlist on YouTube

Clinical Topics on Opioid Addiction is a series of short 5-minute videos presented by J. Kimber Rotchford, M.D., a practicing physician for more than 35 years in the specialty fields of addiction and pain management. 

The message of these videos is directed to: suffering addicts; addicts in recovery; and families and friends of addicts. 

Doctor Rotchford, specialist in Addiction and Pain Management, is the director of the Olympas Pain and Addiction Services (OPAS) clinic in Port Townsend in Washington State. 

Doctor Rotchford's website is www.DrRotchford.com

Friday

Rotchford MD Consult on Pain and Addiction

What is Rotchford MD Consult on Pain Addiction?
Rotchford MD Consult is a specialized provider of consults to physicians, clinics, government agencies and patients in the clinical specialty of pain and addiction. The consult program is developed by and under the medical direction of Kimber Rotchford, MD. Consults serve medical and professional clinics and government agencies throughout the United States. Consultation, diagnosis and treatment are a team effort with professional pain and addiction specialists with Olympas Consult and medical providers representing clinics and patients. Successful treatments employ a combination of medications and behavior modification.

To schedule a consult appointment time, call 360-385-4843.


What is Olympas Consult?

Olympas Consult is a specialized provider of consults to physicians, clinics and patients in the clinical area of pain and addiction. The consult program is developed by and under the medical direction of Kimber Rotchford, MD. Consults serve medical and professional clinics throughout the United States. Consultation, diagnosis and treatment are a team effort with professional pain and addiction specialists with Olympas Consult and medical providers representing clinics and patients. Successful treatments employ a combination of medications and behavior modification.

To schedule a consult appointment time, call 360-385-4843.

Professional Consults

Primary care providers search out clinical support from Olympas Consults in anyone of the following cases:

PAIN MANAGEMENT

1. A primary care provider is treating a patient for acute or chronic pain in a case where the patient needs stronger medications, but the attending physician is hesitant to enter the pain field with controlled substances that potentially increase liability for governmental regulation.

2. A new patient to a clinic has a medical history of opiate dependency and the physician is seeking a consult on best practices and potential liability of prescribing FDA controlled substances.

3. A director of a pain clinic is considering expansion of the clinic's services into higher risk areas of pain management and is looking for guidance on first steps to take to insure maximum compliance with federal and state administrative codes.

More information at Professional.

For an answer to your question, call 360-385-4843.

Clinical Consults

Primary care providers search out clinical support from Olympas Consults in anyone of the following cases:

PAIN MANAGEMENT

1. A primary care provider is treating a patient for acute or chronic pain in a case where the patient needs stronger medications, but the attending physician is hesitant to enter the pain field with controlled substances that potentially increase liability for governmental regulation.

2. A new patient to a clinic has a medical history of opiate dependency and the physician is seeking a consult on best practices and potential liability of prescribing FDA controlled substances.

3. A director of a pain clinic is considering expansion of the clinic's services into higher risk areas of pain management and is looking for guidance on first steps to take to insure maximum compliance with federal and state administrative codes.

ADDICTION TREATMENT

1. A patient is opiate dependent and facing surgery or cancer treatment and the attending physician is hesitant to enter the pain field with controlled substances that potentially increase liability for governmental regulation.

2. A clinic is attempting to treat a patient with a chemical dependency and is searching out alternative treatments.

These are examples of cases for which a consult with Olympas experienced physicians would be appropriate.

More information at Clinical.

For an answer to your question, call 360-385-4843.

Patient Consults

Patients suffering from pain and addiction search out clinical support from Olympas Consults for any one of the following cases:

PAIN MANAGEMENT

1. A patient is suffering from acute or chronic pain and needs stronger medications, but the attending physician is hesitant to enter the pain field with controlled substances that potentially increase liability for governmental regulation.

2. A patient is planning on or has recently completed a surgery and is anticipating or experiencing acute pain and is seeking a consult on alternative medications for management of the pain.

ADDICTION TREATMENT

1. A patient is suffering from acute or chronic pain and needs stronger medications, but the attending physician is hesitant to enter the pain field with controlled substances that potentially increase liability for governmental regulation.

2. A patient is attempting to self treat an addiction to any of a number of chemical dependencies and is searching out alternative treatments.

These are examples of cases for which a consult with Olympas experienced physicians would be appropriate.

More information at Patient.

For an answer to your question, call 360-385-4843.

Thursday

Speaker


Call 360-379-8800 to schedule a talk to your group.


Invite James K. Rotchford, MD to speak to your organization, community, clinic or tribe about the treatment of Pain and Addiction.

What you need to know. Get informed. Learn more. Information on booking a date.

FOUR PART PRESENTATION

Session One: Addiction as a Chronic Brain Disease

If one does not have an understandings of the biological underpinnings of addiction it makes understanding and offering solutions more challenging.

Session Two: Different Strokes for Different Folks

How one manages one addiction often overlaps  with other addictions but the differences need to be appreciated if optimal outcomes obtained.

Session Three: Winning Combinations!

What are some of the basic principles that guide us in promoting optimal outcomes both for patients  and their communities

Session Four: System Approach!

Addictions are socially induced and promoted. What is a system’s approach and why is it so important in the prevention and treatment of addictions.

Read Dr. Rotchford's resume.

To schedule Kimber Rotchford, MD for a speaking engagement with your organization call 360-379-8800.

Acupuncture


Acupuncture

Dr. Rotchford is a founding member of the American Academy of Medical Acupuncture and is a Fellow of the American Academy of Medical Acupuncture.  He has been integrating acupuncture into his medical practice since 1981.   He has taught, published, and spoken internationally on acupuncture related topics.


The Acubriefs database is made up of citations from several sources (More than 24,000 primarily English citations as of February 2007). In addition to standard database sources such as Medline, a number of pertinent non-indexed journals are subscribed to and indexed in Acubriefs's database. Numerous articles and text books have also had their bibligraphies reviewed in order to help complete Acubrief's database.

To view complete list of Acupuncture Listings Go to Acubriefs database

Pain Management

Dr. Rotchford's concepts regarding chronic non-cancerous pain and addiction are "cutting edge"
Alex Cahana, MD, Professor & Chief
Div. of Pain Medicine
University of Washington Medical Center


Pain Management
.    Medical Pain Management Services
   Physician Acupuncture Services


Dr. Rotchford is a seasoned pain management specialist and long standing member of the American Academy of Pain Management.   His pain management strategies  focus on improving brain and spinal cord function.   This is accomplished  through education, behavioral changes,  proper pharmaceutical care, supplements as indicated, and standard medical procedures as well as acupuncture and other "alternative" modalities.   He is accustomed to seeing patients for which his colleagues have no further suggestions regarding their pain management.   He is particularly skilled and experienced with helping patients who have been prescribed opiates chronically.



Partial list of chronic painful conditions treated:


Migraines
Fibromyalgia
Neuropathic Pain
Chronic neck or back pain
Arthritis
Failed back surgery
Regional Pain Syndromes (Formerly Reflex Sympathetic Dystrophy)

Pelvic Pain
Bladder pain


The above can only be a partial list so if there is a condition or service in which you are interested which you do not find listed, please inquire.

Chronic Non-Cancerous Pain is a disease in and of itself.  Dr. Rotchford specializes in this disease.  For more information please review the handouts related to pain management  on the tab related to Handouts -  Some helpful documents and links are available including a talk on chronic pain as a disease.

Access to specialized services in Pain Management are sorely lacking.   Consider writing a letter.

Addiction Medicine


Addiction Medicine

Specialized Medical & Behavioral Management for Addictive Disorders

Dr. Rotchford has over 20 years of specialized interest in addiction medicine and is among the first physicians to be board certified in Addiction Medicine.   He is a past president of the Washington Society of Addiction Medicine and has spoken internationally on addiction medicine subjects.  He has provided CME courses to physicians related to addiction medicine.  He is passionate about helping patients access the best that addiction medicine has to offer.

Note:  Dependence is the current medical term that is equivalent to addiction.  New diagnostic labels arriving later in 2013 will use terms such as substance use disorders (SUDs).  This represents progress in our nomenclature because these "disorders" represent a broad continuum of severity and individualized care is essential for the best results.  
  • Alcohol Dependence
  • Tobacco Dependence
  • Sedative Dependence
  • Cocaine Dependence
  • Methamphetamine Dependence
  • Opioid Dependence
  • Marijuana Dependence
.   Dr. Rotchford has extensive experience and expertise in using buprenorphine for pain management and opioid addiction.
.   Antagonist (Naltrexone) Therapy for opioid dependence

His office also provides  In House Drug Testing as a High Complex Lab

For those with alcohol or methamphetamine dependence one might consider the Prometa program: PROMETA

Be sure to look under the Handouts tab for a list of addiction handouts written or compiled by Dr. Rotchford.


Curriculum Vitae


 RESUME OF PROFESSIONAL MEDICINE
J. Kimber Rotchford, M.D., M.P.H.
CREDENTIALS
2010    President, Washington Society of Addiction Medicine 2009 - 2010
2010    President, Jefferson County Medical Society 2009 - 2010
2010    Founding Member, International Association of Pain & Chemical Dependency 
2009    Diplomat, Board of American Society of Addictive Medicine
2008    Medical Review Officer Certification
2004    Certified in Addiction Medicine
2002    Fellow, American Academy of Medical Acupuncture
2002    Fellow, American Academy of Integrative Medicine
2001    Board Certified in Medical Acupuncture
1992    Board Certified in Public Health and General Preventive Medicine
1992    Fellow, American College of Preventive Medicine
1990    Masters of Public Health, Preventive Medicine Residency, UW School of Public Health
1986    Aviation Medical Examiner, Certificate of Designation
1984    Acupuncture for Physicians, UCLA School of Medicine, Joseph Helms, M.D. Instructor
1980    Doctor of Medicine, University of Washington
1976    Completed two years of medical school at University of Nantes, Nantes, France
1973    Bachelor of Arts, French Literature, University of Washington
1969    William Winlock Miller High School, Olympia, WA

CONTINUE READING AT LINK FOR FULL RESUME

Testimonials

Dr. James K. Rotchford, M.D.

Note:  The  following testimonials were gratuitously provided based on widespread local coverage of Dr. Rotchford's medical practice being stormed by armed local law enforcement and DEA agents. This occurred in December of 2010.   Members of the community were stunned.   No charges were ever made as a result of the thorough investigations by our State's Attorney General's office.  Their concerns related to Medicaid billing irregularities. Dr. Rotchford's DEA registration was returned as well.   The DEA concern was largely related to holding patient prescriptions of controlled substances.   Despite being clinically and professionally indicated for patient safety and public health concerns, the current DEA interpretation of the law does not allow for this.          

TESTIMONIALS
“compassionate . . . knowledgeable . . . generous . . . helpful . . . caring . . . respectful . . . kind and helpful . . . merciful . . . non judgemental . . . professional . . . pain specialist . . . physicians like Dr. Rotchford are becoming more and more rare.“
COMMITTED PROFESSIONAL
“very committed to his patients’ well being . . . devoted his life to helping people . . . trying to help alot of people . . . carefully monitored my medication . . . greatly alleviated the pain. . . rare ability to combine the best of his training in western and eastern medicine to best help his patients.“
SERVICE TO SPECIAL PATIENTS
“helps the outcast . . . works with the most difficult population . . . treats the people the world rejects, the addicted . . . takes care of the chronic narcotic dependent and chronic pain patient.”
VOLUNTEERS EXPERTISE 
“has helped many folks with little or no compensation . . . gave his time for free to people who have no money for insurance . . . donates his medical expertise to the poor at JC MASH free clinic.“
GRATITUDE FROM PATIENTS 
“I do not know what I would have done without him”
“thank you so much for helping the people who cry out for help and no one else will hear them but you.”
“thank you and bless you, Dr. Rotchford”

Dr Rotchford Biography


PRESS RELEASE: 8/23/16 – TITLE: Dr. Rotchford Biography
Contact: Dr. Rotchford, OPAS Clinic
Email: jkrotchford@gmail.com
360-385-4843
Dr. Rotchford Biography

J. Kimber Rotchford, M.D. is one of the leading physicians in the United States with extensive experience and expertise in treating patients with chemical dependencies such as heroin and marijuana, and with chronic, complex pain afflictions, especially addiction to pain medications.

Dr. Rotchford received his Doctor of Medicine from the University of Washington in Seattle, Washington. And, he completed two years of medical school at the University of Nantes in Nantes, France. He completed an internship at Montreal General Hospital affiliated with McGill University in Montreal, Canada.

He is a Fellow of the College of Preventive Medicine, board certified in Public Health and General Preventive Medicine, and board certified in Medical Acupuncture. [View Resume]

Dr. Rotchford is the medical director of Olympas Pain and Addiction Service (OPAS) clinic in Port Townsend, Washington. OPAS is a clinical and referral center for patients struggling with pain and addictions. His approaches are innovative, effective and based on the best medical evidence available.

In addition to memberships in other organizations, Dr. Rotchford is a member of the American Academy of Pain Management and the American Academy of Pain Medicine. He is a founding member of the International Association of Pain and Chemical Dependency. He is a past president of the Washington Society of Addiction Medicine.

Dr. Rotchford speaks at state, national, and international meetings on subjects related to addiction. He has extensive experience and expertise in authoring and evaluating scientific papers. He is a Fellow of the American Academy of Medical Acupuncture. He has written extensively and is published widely in professional, medical journals. [View Resume]

Dr. Rotchford's primary commitment is to the clinical care of his patients. He is passionate about his care for his patients and he is qualified to speak on the diagnoses and effective treatments for patients suffering from debilitating effects of pain and addictions. [Read testimonials]

END

J. Kimber Rotchford, M.D. is the director of Olympas Pain and Addiction Services (OPAS) in Port Townsend, WA. Website: DrRotchford.com 

Access Help


There is serious shortage of  effective medical help for patients with complex chronic pain and substance use disorders.   Patients addicted to pain pills or other opiates often lack access to life saving medical care.  There is an epidemic of opiate misuse.  It could be argued that opiate related problems are one of America's primary public health concerns. What to do?   

 
The first step generally involves helping yourself or a loved one.  Afterwards, we can attempt to heal others and the community at large. 

For yourself or a loved one:

1. Become informed. Even many physicians are ignorant or misinformed of state guidelines related to prescribing controlled substances to patients, particularly opiates.  While pain management expertise is often lacking, the lack of specialized medical care for pain management in the context of substance use disorders, represents a major public health crisis.  


The 2015 revised Washington State Guideline on Prescribing Opioids for Pain is available online at:




On page 40 it reads:  


“ 1. Assess for opioid use disorder using DSM 5 criteria or refer for a consultation with an addiction specialist if a patient demonstrates aberrant behaviors suggestive of substance use disorder (Table 9 and Appendix H: Clinical Tools and Resources). Interagency Guideline on Prescribing Opioids for Pain [06-2015] 41. (Dr. Rotchford would add that if a patient has multiple risk factors for a substance use disorder that alone should prompt a referral.)


2. “Patients diagnosed with opioid use disorder should receive a combination of medication-assisted treatment and behavioral therapies.


Once a moderate to severe opioid use disorder has been diagnosed, there is strong evidence for efficacy of methadone or buprenorphine maintenance combined with behavioral therapies compared to non-medication treatment. (237-239) Maintenance treatment leads to lower rates of illicit opioid use and likely reduces health care utilization and criminal justice involvement. (240-243) There is very little evidence that antagonist therapy with oral naltrexone is effective for patients with opioid use disorder, and there is no evidence in patients with chronic pain. However, it might be considered in selected, highly motivated patients (e.g. impaired professionals). (244)


On Page 41 under evidence it reads:


“There is very little evidence that outpatient non-medication treatment for opioid use disorder is effective. (237,238) In these programs, patients are tapered off opioids and are expected to attend a treatment program one or more days per week to learn skills necessary to manage symptoms (e.g. pain, mood and anxiety problems, substance craving) without resorting to substance use.


Once a moderate to severe opioid use disorder has been diagnosed, there is strong evidence for efficacy of methadone or buprenorphine maintenance combined with behavioral therapies compared to non-medication treatment. (237-239)


Maintenance treatment leads to lower rates of illicit opioid use and likely reduces health care utilization and criminal justice involvement. (240-243) There is very little evidence that antagonist therapy with oral naltrexone is effective for patients with opioid use disorder, and there is no evidence in patients with chronic pain. However, it might be considered in selected, highly motivated patients (e.g. impaired professionals). (244)


Comment:  In all areas of medicine contextual variables must be considered to assure optimal outcomes. (See above where they suggest that naltrexone care might be considered in highly motivated patients (e.g. impaired professionals).   It is Dr. Rotchford’s opinion that if a patient has serious chronic pain management issues or has significant co-morbid mental health issues,  even those patients who have been diagnosed with a mild opioid use disorders warrant a trial of medication assisted treatment.  It is indicated based on the evidence,  if for no other reason,  to help minimize complications and promote good outcomes with  co-morbid conditions.  

The above is formal and state approved guidelines to help educate your physician of their professional responsibility to assist you in obtaining Medication-Assisted Treatment (MAT), particularly if you so choose.


2.  Obtain a formal pain management or addiction medicine consult.   These are unfortunately difficult to come by.  Ask your doctor for suggestions. 

There are many ways a pain management and an addiction medicine specialist can help patients:
  • Work with other prescribers to assure that a patient is prescribed the safest and most effective medical regimen.
  • Provide FDA approved medical care for for addictions. Besides buprenorphine, naltrexone is another FDA approved medication that can  be helpful for treating opiate addiction and alcohol use disorders. It may also be used to help in some cases of chronic pain. 
  • There are non-pharmacological ways to manage pain and addictions. Since the early 1980s I have provided medical acupuncture and am skilled in a host of ways to treat pain without the use of addictive substances.
  • There are effective treatments to help patients limit withdrawal symptoms. Much support is available even without the use of a controlled or addictive substance.
  • There are a host of medications, supplements, and behaviors that promote healthy pain management and brain function. The best care is individualized.
3. Seek help, whether with Dr. Rotchford or others:


Community wide action steps and support material:
Please let us know other ways you have found helpful in finding effective medical care for your condition(s). We support interested family members, parents, friends, and others to come together to help create a political force that would encourage state policy makers to effectively address the medical needs of patients with complex chronic pain or substance use disorders.   If you are interested in such a group our office has started to put together a list of interested persons.  Without grass root's political pressure it is unlikely the lack of access will effectively change.