Halting a Crisis

Introduction to a new series

There is no escaping the news that more people are addicted to painkillers and dying from drug overdoses. By now, any one of us could probably offer their own, personal story about a family member, a neighbor or a friend of a friend who has struggled with managing pain – sometimes to the point of addiction or death.

This month, the U.S. Surgeon General sent a letter to more than 2.3 million health care practitioners and public health leaders, asking for their help with the prescription opioid crisis. (Scroll down to read the full letter.) Since 1999, the number of overdose deaths involving prescription opioids has quadrupled, according to the Centers for Disease Control and Prevention. Prescription opioids are involved in at least half of all U.S. opioid overdose deaths, says the agency.

So, in response to the national opioid epidemic, we will be presenting a series of articles asking this question: How are medicine and pharmacy students at NEOMED being taught to deal with this huge community and societal problem?

We’ll be looking into how students are learning to help patients of all ages and backgrounds cope with pain, whether in community clinics, hospitals, private practices, pharmacies or emergency rooms. We’ll also take a look at recent legislation, and how it has changed training and approaches.

Watch for the first article. We will welcome your comments.

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Here’s the letter sent by the U.S. Surgeon General:

UNITED STATES SURGEON GENERAL
Vivek H. Murthy, M.D., M.B.A.
August 2016

Dear Colleague,

I am asking for your help to solve an urgent health crisis facing America: the opioid epidemic. Everywhere I travel, I see communities devastated by opioid overdoses. I meet families too ashamed to seek treatment for addiction. And I will never forget my own patient whose opioid use disorder began with a course of morphine after a routine procedure.

It is important to recognize that we arrived at this place on a path paved with good intentions. Nearly two decades ago, we were encouraged to be more aggressive about treating pain, often without enough training and support to do so safely. This coincided with heavy marketing of opioids to doctors. Many of us were even taught – incorrectly – that opioids are not addictive when prescribed for legitimate pain.

The results have been devastating. Since 1999, opioid overdose deaths have quadrupled and opioid prescriptions have increased markedly – almost enough for every adult in America to have a bottle of pills. Yet the amount of pain reported by Americans has not changed. Now, nearly 2 million people in America have a prescription opioid use disorder, contributing to increased heroin use and the spread of HIV and hepatitis C.

I know solving this problem will not be easy. We often struggle to balance reducing our patients’ pain with increasing their risk of opioid addiction. But, as clinicians, we have the unique power to help end this epidemic. As cynical as times may seem, the public still looks to our profession for hope during difficult moments. This is one of those times.

That is why I am asking you to pledge your commitment to turn the tide on the opioid crisis. Please take the pledge. Together, we will build a national movement of clinicians to do three things:

First, we will educate ourselves to treat pain safely and effectively. A good place to start is this pocket guide with the CDC Opioid Prescribing Guideline. Second, we will screen our patients for opioid use disorder and provide or connect them with evidence-based treatment. Third, we can shape how the rest of the country sees addiction by talking about and treating it as a chronic illness, not a moral failing.

Years from now, I want us to look back and know that, in the face of a crisis that threatened our nation, it was our profession that stepped up and led the way. I know we can succeed because health care is more than an occupation to us. It is a calling rooted in empathy, science, and service to humanity. These values unite us. They remain our greatest strength.

Thank you for your leadership.

Vivek H. Murthy, M.D., M.B.A.

Photo credit: Chris Yarzab | CC BY