Moments before a cluster of congressmen began their 9:30 a.m. presentation at the 2016 National RX Drug Abuse and Heroin Summit in Atlanta Wednesday, the grim clock above them stood at 6,970: the number of people dead from an opioid or heroin overdose in the roughly 72 hours since the summit began Monday evening.
When the speakers arrived at the dais, it was 6,970.
The Director of the Centers for Disease Control this morning joined a growing list of high-ranking government officials pointing fingers at physicians who have prescribed enough opiate painkillers for every American to have their own stash.
Speaking at the National RX Drug Abuse and Heroin Summit in Atlanta, CDC Director Dr. Tom Frieden said that although drug cartels have improved management of their supply chains and flooded the country with cheaper and more potent heroin, 75 percent of new heroin addicts say they started with prescription drugs.
“What we’ve said to doctors is remember that any single one of those prescriptions could ruin or end a patient’s life,” Frieden told an audience of hundreds of substance abuse stakeholders at the morning’s keynote session. “Prescription drugs are now gateway drugs.”
Although stopping short of blaming doctors and dentists who prescribe addictive painkillers, Frieden said reducing the supply with better prescribing practices coupled with law enforcement efforts would have a significant impact on the supply of drugs available.
“We know of no other med routinely used that kills patients so frequently and it’s dose related,” Frieden said.”I’m sorry but at the CDC we don’t sugar coat it.”
A survey released by the National Safety Council on Tuesday found 99% of doctors are prescribing opioid medicines for longer than the three-day period recommended by the CDC. Twenty-three percent said they prescribe at least a month’s worth of opioids. Evidence shows that 30-day use causes brain changes, according to the survey.
“I’m from the north,” Marsha Martino told about 60 people gathered Tuesday for a panel discussion on the mental health epidemic in Palm Beach County. “I have never lived in a place so devoid of services.”
She spoke to a Leadership Palm Beach County class of about 60 at The Palm Beach Post on a panel with Palm Beach County Sheriff’s Chief Deputy Mike Gauger, Palm Beach County Circuit Judge Joseph Marx and Peter Davey, a young man who has battled mental illness.
The system here makes it hard on the mentally ill, Martino said.
Released from treatment, a mentally ill person likely must wait six weeks for treatment. For some, the act of remembering an appointment six weeks away is an “insurmountable barrier,” she said.
In Maine, she said, a patient would be seen by a team of mental health professionals the next day.
Marx, who presides at first-appearance court, said he sees tragedy daily. When mentally ill individuals are arrested, they lose their job, which means they can’t pay for housing, which means they lose their daily shower and shave, which means they lose the chance to get a job, Marx said.
“They have nowhere to sleep. They’re sleeping in your neighborhood,” he said.
One repeat offender, arrested for having an open container, begged the judge to send him back to jail. “I’ve hit bottom,” the man told Marx.
The judge sought a bed for the man. Nobody had one. Finally, he found a place willing to provide a bed for free. He released the man, ordering him to appear in court two months later.
He did, the judge said. And he was good.
“Judge, you saved my life,” the man told Marx.
Without prompting, the man came back again 30 days later to show the judge he was still clean, still working.
“Nine out of 10 do not come back,” Marx said. “But isn’t it worth the effort?”
But such efforts don’t soothe the populace, Marx said. He hears: “Judge aren’t you getting soft on crime?”
“No,” he says. “I’m getting smart on crime.”
Parental denial is one of the biggest problems, Gauger said. He pointed to the Sandy Hook killer, Adam Lanza, to illustrate.
“Many families are absolutely in denial when it comes to substance abuse or mental health issues,” the No. 2 official to Sheriff Ric Bradshaw said. “That’s what Adam Lanza did. He locked himself in the room and to entertain him, his mother took shooting and to buy weapons.”
Lanza killed 20 children and six adults before killing himself in December 2012 at the Sandy Hook Elementary School in Newton, Conn.
Awareness is key, the panelists agreed. As is ending the stigma.
Paraphrasing the words of Mother Teresa, panelist Davey said, even when they act badly “love them anyways.”
Health and Human Services (HHS) is issuing a proposed rule to increase the current patient limit for qualified physicians who prescribe buprenorphine to treat opioid use disorders from 100 to 200 patients. HHS had already released $94 million in new funding to 271 community health centers, with a specific focus on expanding medication-assisted treatment of opioid addiction and abuse- it could assist 124,000 new patients.
The Substance Abuse and Mental Health Services Administration (SAMHSA) is releasing a $11 million for up to 11 states to expand medication-assisted treatment for addiction.
Back to HHS: Information on HHS-funded programs regarding the use of federal dollars to start or expand needle exchanges. Obama last year reversed the longstanding ban on federal money for such programs.
Also from the White House, an announcement that more than 60 medical schools, beginning in fall 2016, will require their students to take some form of prescriber education, the better to curb the kind of prescribing that has resulted in 215 million U.S. prescriptions for narcotics every year. The only Florida school named: University of Central Florida College of Medicine.
“Very rarely is money the answer alone,” said Obama to a crowd of about 2,000. “But it helps.”
In an echo of former Surgeon General C. Everett Koop’s historic letter to 107 million households regarding the AIDS epidemic, Murthy is drafting letters to more than one million doctors, dentists and other health care providers in a call for action on the opiod epidemic.
It’s particularly targeted move: It’s physicians who have driven the opiod epidemic with massive numbers of narcotics prescriptions, Murthy and others at the Summit have pointed out.
Every year, Murthy said, another 215 million new opiod prescriptions are written, “enough to put a bottle of pills in the hands of every adult American.”
But, he said, doctors have gotten bad information, both about the addictive potential of drugs such as oxycodone, and addiction overall. For instance, physicians beginning in about 1996 were being taught that fewer than one percent of all patients treated with narcotics were likely to become addicted. State medical boards warns of sanctions against doctors who failed to aggressively treat pain.
“Far too often, doctors have been in situations with patients who they believed were addicted to opiods,” said Murthy, but, he said, physicians did not have the education or tools needed to know whether their prescriptions were alleviating pain or feeding an addiction.
Murthy isn’t stopping with a letter. He’s compiling the first report of any surgeon general addressing substance abuse, addiction and health.
Like the letter, such reports carry clout: Think the tobacco report in 1964 on tobacco and the 1987 report on HIV/AIDS, both of which moved the needle on public discussions of major health issues.
And, like Koop, Murthy intends to use his position as a bully pulpit to educate.
“I want to help the country see that (addiction) is not a moral failing, but a chronic illness that we need to treat with compassion, urgency and skill.”
Fought for since 2001, approved in 2009 and finally operational in October 2011, the database curbs doctor shopping for opioids by tracking prescriptions for the drugs.
It’s been wildly successful at curbing oxycodone-related overdose deaths in Florida, as its latest report shows. In fact, it’s considered a model for other states of just how effective such a database can be.
At a Summit seminar Tuesday morning, there was a discussion by program manager Rebecca Poston of possibly broadening its scope, by linking it to other databases, such as the database of drug-related deaths compiled annually by Florida medical examiners, or the state database on Hepatitis C infections.
The idea is to provide a sweeping look at Florida public health issues, particularly as it involves patterns of drug use.
Nothing on that scale is happening yet. Whether it occurs depends in part on the University of Florida securing a grant which would fund such a program. (EForcse gets no state money for its operations.)
But it raises a question of whether Florida’s lawmakers would resurrect the same privacy concerns they raised back in 2009 and later when arguing against establishing the prescription monitoring database at all.
Poston points out that, as envisioned, there would be no way an individual could be identified. You could not, for instance, be able to individually link Adam Smith to his oxycontin prescriptions, then his treatment for Hepatitis C, his medical treatment for addiction or his death from an overdose. The data would have no names attached.
Post reporters Christine Stapleton and Pat Beall are covering the Summit live from Atlanta. Look for continuing updates on The Insider blog.
Michael Botticelli, Director of the White House Office on Drug Control Policy, will join the heads of the Food and Drug Administration, that National Institutes of Health and the Substance Abuse and Mental Health Services Administration to discuss updates in federal drug control policy and initiatives.
The speakers highlight the morning session at the National RX Drugs & Heroin Summit in Atlanta. President Obama will participate in a panel discussion this afternoon. Other panel members include Justin Luke Riley, president and CEO of Young People in Recovery.
Follow the Post’s live coverage of the summit on The Insider Blog.
Taking the wraps off a pair of new federal efforts to address addiction in rural America, Tom Vilsack did the expected thing, the sorta-surprising thing and the totally knock them right out of their socks thing.
After announcing that his agency would be giving out $1.4 million in grant money to assist in researching opiate addiction in rural America, and that he would take part in a series of town halls in states hard-hit by the drug crisis, Vilsack explained the origins of his concern.
“I started life in an orphanage in Pennsylvania” before being adopted, he said. It was a loving home, but there was a problem tearing it apart: “My mom had a prescription drug addiction and she was violent. She was mean. She tried to commit suicide a couple of times.
“It was a tough situation. My parents split up for a period of time. I nearly flunked out of high school.”
He said he judged her harshly, something he now regrets.
“I thought all she had to do was stop taking medications. I did not realize that at that point in time, we were dealing with a disease.”
But, Vilsack said, “on December 25, 1963, she realized she hit bottom.”
His mother got sober, said Vilsack. “She could not have done that without a 30-day treatment program. She could not have done it without a supportive community.”
With an estimated 78 Americans a day dying from prescription opioids, Vilsack said, entire communities now need to step up: Pastors and community leaders as well as doctors and government.
“Person by person, we can do this,” he said. “We must do this.”
The Indians finished 81-80 and missed the playoffs. The Kansas City Royals, who won the World Series, weren’t even picked by the magazine to make the playoffs.
Perhaps the Astros are destined to become the latest victims of the Sports Illustrated jinx, the urban legend in which sports figures who appeared on the front of the magazine have come down with injuries, lost big games or suffered some other unfortunate misfortune.
The Astros and Washington Nationals will share the $144 million complex south of 45th Street next year.
Reporter to woman: Are you here for the conference?
Woman: Yes, I’m from Detroit.
Reporter: We’re from South Florida.
Woman: Oh, South Florida. That’s where you go when you’ve got money for treatment.
On Monday, Health and Human Services released a report on just how many Floridians with addiction or mental health issues can’t get adequate help – in some cases, any help – because the state won’t expand Medicaid, a key feature of Obamacare.
(Comes a day before President Obama is slated to speak at the Summit. Coincidence? You decide.)
About three in every ten people living below 138 percent of the poverty level need treatment for drug abuse or mental illness or both, HHS estimates.
From those numbers, the feds put together these numbers in the report:
390,000: Number of uninsured Floridians age with either mental illness or an addiction problem who would qualify for treatment under Medicaid expansion. (For bragging right purposes, that’s second only to Texas among states without Medicaid expansion.)
Nine: Percentage of uninsured Floridians getting help for the above, 2010-14.
$7 million-$190 million. Budget savings range reported by different states which expanded Medicaid.
17, 18, 33: Percentage drop in arrests among three groups of people frequently in trouble with the law after Washington state began providing them with Medicaid-financed substance abuse treatment.
Stay tuned as Post reporters Christine Stapleton and Pat Beall cover the Summit live from Atlanta. Stapleton and Beall are members of a team of reporters that have been investigating scams in Palm Beach County’s $1 billion drug treatment industry