what we do
The overutilization of opioids by clinicians and hospitals is one of the major drivers of the nation’s opioid epidemic. In addition to the long-term risks of dependence and addiction associated with opioid use and prescription, the evidence is clear that opioids are ineffective for management of many painful conditions and may, in some cases, complicate pain management.
The misconception that opioids are the gold-standard for pain management is outdated and dangerous. By utilizing multimodal analgesia with alternatives to opioids (ALTO), clinicians can treat pain more effectively while simultaneously reducing the risks associated with opioid exposure. Dr. Stader and his team have developed and implemented ALTO programs in emergency departments and hospitals across the nation. Dr. Stader and clinical pharmacist Rachael Duncan founded the nation’s second emergency department ALTO program(https://www.cpr.org/2018/01/25/if-hospitals-can-change-their-approach-to-pain-they-can-cut-into-the-opioid-epidemic/), published the first academic study showing the effectiveness of emergency department ALTO programs (https://www.ncbi.nlm.nih.gov/pubmed/29709398) and created the nation’s first guidelines promoting ALTO as standard of emergency department care (https://coacep.org/docs/COACEP_Opioid_Guidelines-Final.pdf). SOC’s clinicians have been leaders in efforts to promote use of multimodal analgesia and ALTO programs for other medical specialties, crafting pain management guidelines for hospitalists, obstetrician-gynecologists, surgeons, anesthesiologists and dentists, with guidelines for other specialties currently under development. The consultants at SOC have trained more than one hundred hospitals and thousands of clinicians across the country. In addition, Dr. Stader has been instrumental in lobbying for federal law to help fund ALTO (https://www.govtrack.us/congress/bills/115/s2516/text). SOC is dedicated to helping hospital systems, physician groups and health departments develop and implement effective, evidence-based programs to improve pain management and decrease opioid use.
Opioid overdose is the leading killer of Americans under the age of 50. More than 2 million people in the United States have opioid use disorder (OUD), and more than 19 million report misusing opioids in the past year. While OUD is all-too-common, access to treatment is not. The vast majority of people with OUD do not receive evidence-based treatment, and most hospitals, emergency departments and health systems do not offer medication for addiction treatment (MAT).
MAT with methadone, buprenorphine or naltrexone dramatically improves patient care. The evidence behind MAT is robust; it has been shown to reduce mortality by 70%, decrease transmission of blood-borne pathogens (hepatitis B, hepatitis C, HIV), decrease the incidence of soft tissue infections and endocarditis, decrease criminality by 80% and dramatically improve the quality of people with with OUD.
SOC has the experience and expertise necessary to assist hospital systems and states in developing and implementing MAT programs. In Colorado, SOC worked with the Colorado Hospital Association and the Colorado Office of Behavioral Health to create ColoradoMAT.org (https://cha.com/opioid-safety/coloradomat/), a statewide plan with tools to implement MAT in hospitals statewide. Spearheading the CO’s CURE initiative, SOC is developing MAT guidelines for more than a dozen medical specialties. We have helped hospitals launch buprenorphine programs and collaborated with our partners at OpiSafe (https://opisafe.com) to help hospitals and MAT providers connect with one another to facilitate patient care. In addition, Dr. Stader and SOC have been leaders in integrating recovery support specialists into Colorado emergency departments, securing grant funding to integrate recovery support into emergency department practice. For health care clinicians and organizations whose aim is to develop and implement MAT initiatives, build systems of care for OUD or integrate a recovery support specialists into their practice models, SOC’s consulting expertise may be a valuable resource.
SOC is committed to educating clinicians, patients and families on the principles of harm reduction, including access to naloxone and overdose education. As the opioid epidemic has transitioned from prescription to illicit opioids, the importance of harm reduction strategies has grown. Better safety education for patients who inject drugs and access to syringe exchange saves lives and protects the health of these vulnerable patients until they are ready to enter treatment. Access to naloxone and overdose education is a common sense, evidence-based approach to decrease overdose deaths and is endorsed by the Surgeon General, the World Health Organization, the American Medical Association and numerous other organizations.
SOC is a leader in bringing harm reduction principles and practices to hospitals and clinicians. The consultants of SOC wrote the first medical guidelines championing harm reduction as a pillar of care to address the opioid epidemic ( https://coacep.org/docs/COACEP_Opioid_Guidelines-Final.pdf) SOC clinicians wrote the first hospital guidelines championing take home naloxone as a new standard of care andhas helped hospitals develop harm reduction initiatives and create home naloxone programs(https://cha.com/wp-content/uploads/2019/10/CHA.179-Naloxone-Guidelines_final.pdf). Dr. Stader is a well-known national lecturer on harm reduction and facilitating collaboration between harm reduction agencies such as syringe exchange programs and hospitals. Moreover, Dr. Stader has been successful in writing and passing state laws that help hospitals implement harm reduction practices (examples). SOC can provide guidance on incorporating harm reduction into any clinical practice setting and is prepared to assist private and public health care organizations in developing and implementing effective, sustainable naloxone distribution and harm reduction programs
SOC recognizes the importance of creating policies and guidelines that are evidence-based, work for clinicians and health systems and improve patient care. Dr. Stader and his team at SOC have been national leaders in creating guidelines aimed at limiting opioid use and prescription, promoting use of alternatives to opioids (ALTO) and providing optimal care for patients with opioid use disorder (OUD). Dr. Stader is the editor-in-chief of COACEP’s 2017 Opioid Prescribing & Treatment Guidelines ( https://coacep.org/docs/COACEP_Opioid_Guidelines-Final.pdf), which helped launch ALTO as a nationwide movement and led to the creation of the Colorado ALTO project, which has trained over 90% of Colorado hospitals in ALTO implementation. Dr. Esty and Dr. Stader are the editors of the nation’s first naloxone guidelines for hospitals (https://cha.com/wp-content/uploads/2019/10/CHA.179-Naloxone-Guidelines_final.pdf). SOC is spearheading one of the nation’s largest and most collaborative guideline-writing projects, CO’s CURE (The Colorado Opioid Solution: Clinician’s United to Resolve the Epidemic: https://cha.com/wp-content/uploads/2019/03/CHA.149-CO-CURE_Flyer_2.pdf)
The CURE initiative brings together 14 medical specialties in an effort to write guidelines that coordinate the efforts of multiple specialties around the pillars of limiting opioids, ALTO, harm reduction and treatment of OUD. For states and organizations looking to craft policies and guidelines or adopt evidence-based practice in any area related to opioid use, SOC can provide experience and expertise.
Dr. Stader, Rachael Duncan and the team at SOC are well-known national lecturers on the topics of ALTO, opioid stewardship, harm reduction and medication for addiction treatment (MAT). In addition to their efforts on the speaking circuit, the team at SOC are enthusiastic supporters of durable, free open-access medical education (FOAM). Dr. Stader is the founder of the Emergency Medical Minute, a 501c3 nonprofit medical podcasting organization (link) which frequently produces content for clinicians aimed at addressing the opioid epidemic. Founder and president of Triage Films, a physician-owned documentary film company,.Dr. Stader produced the Emmy award-winning film24/7/365: The Evolution of Emergency Medicine (link) and Palliative (link). As a former high school science teacher Dr. Stader values effective education, believing that to have maximal impact, education must be entertaining and thought-provoking; with that guiding conviction, dozens of podcasts, motion animation videos and training videos. The members of SOC are available to speak at events on a range of topics and to help organizations develop innovative, durable audio or visual educational materials. Please see samples of our audio & video materials on our Previous work page (link)
Policies, Guidelines & Other Writing
News & Media Coverage
Podcasts & Videos
We are medical professionals striving to leave a positive impact on our community and our country
DON STADER - FOUNDER & PRESIDENT
Don Stader, MD, FACEP is an emergency physician, innovator & entrepreneur. He practices at Swedish Medical Center in Englewood, CO where he serves as the department’s Associate Medical Director. Don holds a medical degree with honors from Baylor College of Medicine, where he was an Albert Schweitzer Fellow and attended emergency medicine residency at Carolinas Medical Center. He serves on the Colorado ACEP Board of Directors and is the former President of the Emergency Medicine Residents’ Association (EMRA).
Don is an expert on opioid use disorder, policy and clinical approaches to decrease opioid usage, manage pain and treat addiction from the ED. He chairs Colorado ACEP's Opioid Task Force, serves on Colorado Medical Society's Prescription Drug Abuse Task Force, is an Opioid Expert Consultant for Colorado Hospital Association and is the Editor-in-Chief of their 2017 Opioid Prescribing & Treatment Guidelines.
In addition to medicine, he co founded and works as a film producer for Triage Films LLC and was the creative force behind the Emmy-winning documentary 24|7|365 - The Evolution of Emergency Medicine. He is the founder and chair of two non-profit organizations, The Emergency Medical Minute which provides free online emergency medical education and The Last Words Project which allows individuals with terminal conditions or dangerous vocations to speak their last words on their terms through recording posthumous messages for their loved ones. He lives with his wife Andi and daughters Josiphine, Morgan and Audrey in Golden, Colorado.
Elizabeth graduated from Harvard College with a concentration in philosophy, with a focus on the philosophy of language. An honors graduate of Tufts Medical School, Elizabeth left residency to raise her three children in Greenwood Village with her husband, Dylan. A life-long musician, Elizabeth serves on the board of UpBeat Colorado, an organization committed to providing kids from low-income families with high-quality music education. In her work with SOC, Elizabeth takes a particular interest in patient and clinician education, multimodal analgesia, and adolescent behavioral health. In her free time, Elizabeth loves to hike, skate ski, practice yoga and read fiction.
Rachael Duncan, PharmD BCPS BCCCP is a clinical pharmacist that practices in the Critical Care Units and Emergency Department (ED) at Swedish Medical Center in Englewood, Colorado. She earned her doctor of pharmacy degree from Ohio Northern University in 2011 and completed a post-graduate critical care residency at Duke University Medical Center in 2013. In 2016, Rachael joined the Colorado ACEP’s Opioid Task Force and championed the Alternatives to Opioids (ALTO) section. She then led an initiative to decrease opioid usage in the Swedish ED by utilizing the ALTO approach laid out in the guidelines; she subsequently published the first paper showing overwhelming success of a comprehensive ED ALTO program in the American Journal of Emergency Medicine. Her efforts sparked the interest of the Colorado Hospital Association, and the ALTO pilot has now been implemented in the majority of Colorado EDs. Rachael continues to work as a pharmacist consultant on various opioid reduction and treatment projects for Colorado Hospital Association. She lives in Salida, Colorado with her husband and son, “the Charlies.”
Ryan Tsipis - Project Manager
Ryan graduated from Virginia Tech in 2012 with a BS in Human Development and Psychology and played on the varsity lacrosse team. She completed a postgraduate Project Management Certificate at Georgetown University in 2016. Ryan is a May 2020 candidate for a Master of Public Health degree at the Colorado School of Public Health with a focus in Community and Behavioral Health. Along with graduate school, Ryan works part-time as a Data Assistant at Water For People, an international water and sanitation non-profit organization. Outside of work and school, Ryan enjoys being an indoor cycle instructor at the Denver Athletic Club and being outdoors with her husband, Nick, and dog, Gladstone.
Nathan Novotny - Project Manager
Nate graduated from the University of Colorado Denver where he earned a BS in Biology and a BA in English. He will be attending Tulane School of Medicine as a member of the class of 2024. He is also the Executive Director of Emergency Medical Minute, a non-profit, medical education organization. In his free time, he competes in powerlifting and enjoys film, literature and discovering new music.