Episode 4: Addressing the Recent Trends in the Opioid EpidemicFriday, October 8, 2021
Countering the Opioid Crisis: Time for Action Podcast
Click here if you are interested in listening to the full episode hosted by the National Academy of Medicine.
In this episode, Ruth Katz hosts Dr. Rachel Levine, the U.S. Assistant Secretary for Health and co-chair of the NAM’s Action Collaborative on Countering the U.S. Opioid Epidemic, and Brad Finegood, Strategic Advisor in Public Health in Seattle & King County in Washington State.
Below are some of the highlights that I took away from the podcast:
- Across America there are increases in substance use and have experienced a startling rise in overdoses since the COVID-19 pandemic. If we only focus on the statistics then we lose the connection that those are peoples loved ones and family members, and that people are struggling with mental health and social isolation from the pandemic.
- Dr. Levine points out that there is a rise of mental health issues and also polysubstance use. A lot of people are using opioids with stimulants or other drugs.
- Brad talked about an alert they got in October of 2019 where 4 teenagers died of an drug overdose which was alarming because normally they would only see about 4 or 5 teenagers die of an overdose in a given year. What they found on the west coast is that the drug supply and the drug lethality. They saw an influx of fentanyl coming into their communities in the form of counterfeit pills that where made to look like legitimate pills that you would get from a pharmacy.
- Dr. Levine made a good distinction that the increase in fentanyl overdoses and death is not fentanyl the medication used in hospitals but synthetic fentanyl.
- We need to engage the community and go to the people and ask them how we need to improve our systems of care. We need to directly ask them what they need and then follow through with those changes. This will increase the number of people coming through the door for treatment.
- Dr. Levine says that the health and human services wants to make telehealth services a permanent solution for substance use disorder treatment. They also agree with removing the x waiver but that needs to be an act of congress so while that barrier has been temporarily removed during the pandemic to make it permanent congress needs to approve (note: an x-waiver gives medical professionals permission for outpatient use of buprenorphine for the treatment of opioid use disorder).
- For people with stimulant use disorder there are not any medication treatment options for them. Studies are showing some promise but there isn't anything that. What does work is contingency management which would give incentives to people for participating in the behaviors that you want. So, it could be a reward of food or gift cards, etc.
- Public-Private relationships are very important to getting people treatment for substance use disorder. We cannot rely alone on government actions but creating those partnerships with the private sector and medical community to address the problem more efficiently.
- The host, Ruth Katz, asks the guests two final questions, "What is the one thing we can and should do at the federal, state, and local level to address the opioid epidemic? What is the one thing that we can and should do longterm to address the broader issue of addiction?"
- Dr. Levine: Collaboration between the local, federal, and state levels. Focus on harm reduction, prevention, reversing overdoses, treatment, and getting people into longterm treatment. Long term we should remember concepts like social determinants of health and health equity. So, we need to make treatment easily available for everyone and also factor in things like housing and access to food as part of their treatment for substance use disorder.
- Brad: In the short term we should focus on reducing stigma and adopt an all hands on deck approach to the overdose crisis. Long term we should focus on social determinants of health and look at different countries around the world to see what has worked for them and adopt those practices here in the US.
Macomb Partnership for Overdose Prevention