Meet a Graduate: Dr. Gloria Farris
Like many across the U.S., Dr. Gloria Farris’ community is struggling with the opioid epidemic. “It’s hard to see people in your family and in the neighborhood where you grew up strung out on drugs,” she says. “For some, it stemmed from a dentist visit, and for others, their medication got into the wrong hands. Regardless of how it began, the truth is, where I live, if people don’t have money, then they can’t get help.”
As a nurse practitioner, Dr. Farris, a ’17 Doctor of Nursing Practice (DNP) graduate, made in-home assessments and noticed a lot of patients on pain medicine who were not managing it correctly and using it to the point where they were extremely dysfunctional. “When does it stop? Why are we overtreating? Are they truly in pain?” she wondered.
Inspired to answer these questions and help others, she embarked on her doctoral study to introduce an evidence-based screening tool that will identify patients who are at risk of opioid misuse and aid in the development of the most effective treatment plan to manage chronic pain and avoid abuse. “I was sick of watching people walk into pain management clinics switching from one drug to another. And if they don’t get what they need there, they choose heroin or go for the cheaper synthetic drugs. It was like watching vampires,” she says.
Dr. Farris partnered with a doctor at a pain management clinic in Indianapolis, which was experiencing endemic drug use similar to her hometown in rural Alabama. “Drug misuse is impacting people everywhere and from all walks of life,” she says. “What gave me hope was that Dr. Greenmack also didn’t like what she was seeing in her community and was searching for a screening tool that would quickly assess what she was prescribing to patients.”
Two common screening methods are the Diagnosis, Intractability, Risk, Efficacy (DIRE) tool, which can be too time-consuming, and the Opioid Risk Tool (ORT), which often doesn’t provide enough information. “Primary care physicians are also supposed to check the statewide electronic database that tracks controlled substance prescriptions, part of the prescription drug monitoring program, as well as count patients’ pills, but they don’t always follow through, often due to time constraints and other factors,” explains Dr. Farris.
With a lack of evidence-based measurement tools for screening, Dr. Farris’ research helps with the introduction of a reliable tool for assessment. For her doctoral study, Screening for Opioid Misuse and Abuse in Chronic Pain Patients, Dr. Farris utilized the Screener and Opioid Assessment for Patients With Pain (SOAPP), an existing tool that provides an estimate of the potential for overprescribing and abuse. Those who agree to the questionnaire and score a 7 or higher are at high risk. The results are shared with the primary care physician or nurse practitioner, who then reviews the findings and discusses pain medication with the patient. “It’s important to monitor patients closely and place those at high risk on alert to make sure they don’t cross over to abuse or overdose,” she says.
Dr. Farris says her 20-year history as a nurse allows her to talk to patients about their problems, and take their personal history of symptoms and signs and correlate that with some of the other effects of opioids. “Opioids affect different body systems, and now with my DNP, I feel more confident making those connections, educating patients, and providing different options for treatment,” she says.
Currently, Dr. Farris is providing long-term care, managing patients in a nursing home who are on opioids and have other medical issues. One day she would like to open a drug rehabilitation center and help those who have nowhere to go. But for now, she hopes pain management providers find the SOAPP tool helpful in treating their patients with chronic pain and addiction.