Doctor, you’ve got mail. The Surgeon General would like you to read it.

Surgeon General Vivek H. Murthy
Surgeon General Vivek H. Murthy

Doctor, you’ve got mail.

Not stamped yet, not even in the envelope, but it’s as good as done, said Surgeon General Vivek H. Murthy Tuesday afternoon at the 2016 Summit on RX Drug Abuse and Heroin in Atlanta.

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.”

Former Surgeon General C. Everett Koop used his position to influence public discussion of HIV/AIDS.
Former Surgeon General C. Everett Koop used his position to influence public discussion of HIV/AIDS.

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.”

Will Florida’s prescription monitoring database broaden to share anonymous information?

Deaths linked to prescription oxycodone in Florida plummeted after drug monitoring database was adopted.
Deaths linked to prescription oxycodone in Florida plummeted after drug monitoring database was adopted.

Tallahassee could probably feel the love emanating all the way from the second floor of the Westin Peachtree in downtown Atlanta Tuesday morning: The object of affection at the 2016 Summit on RX Drug Abuse and Heroin is Florida’s Prescription Drug monitoring database, or EForcse.

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.

 

Obama’s top drug-abuse officials discuss strategy to deal with opioid crisis

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.

In unexpected moment, Agriculture Secretary Tom Vilsack reveals a life torn by addiction

Secretary of Agriculture Tom Vilsack
Secretary of Agriculture Tom Vilsack

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.

Left sockless was a group of more than 1,000 people attending the  2016 Summit on RX Drug Abuse and Heroin in Atlanta.  Vilsack, head of the U.S. Dept. of Agriculture, was among the opening speakers at the Summit Monday. Tuesday afternoon, his boss – that would be the President- will show up for what is described as a Town Hall meeting.

But Monday night, it was Vilsack’s turn.

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.”

 

 

 

 

Fed report: More Medicaid equals fewer addiction troubles in Florida

Hypodermic needles found in the trash at a cottage apartment by Jean Thomas, 83, in West Palm Beach's Prospect Park neighborhood. (Thomas Cordy / The Palm Beach Post)
Hypodermic needles found in the trash at a cottage apartment by Jean Thomas, 83, in West Palm Beach’s Prospect Park neighborhood. (Thomas Cordy / The Palm Beach Post)

Elevator scene from the National RX Drug Abuse and Heroin Summit in Atlanta:

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.

Or not.

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.)

Anyway: Florida has fought tooth and nail against any such expansion, even though the rolls of Floridians on the health plan for the poor continues to rise.

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.

We already tackled one tricky addiction math question this morning, one raised by this festive magazine cover.

Harpers' controversial piece on legalizing drugs- all drugs.
Harpers’ controversial piece on legalizing drugs- all drugs.

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

The 8-month long investigation by the Palm Beach Post uncovered patient brokering, insurance fraud and kickbacks.

 

Four million vs. 24 million: How many addicts are there in the U.S.?

Credit writer Dan Baum points for timing. But math? Maybe not.

Baum authored a recent Harpers magazine article suggesting that legalizing drugs might be the answer to the current fix we are in.

Harpers' controversial piece on legalizing drugs- all drugs.
Harpers’ controversial piece on legalizing drugs- all drugs.

His Sunday  interview on NPR about the legalization idea out there just hours before an estimated 1800 gather in Atlanta for the National Rx Drug Abuse & Heroin Summit. Among the attendees: President Obama, as well as the head of the DEA, the Surgeon General, the head of the National Institute on Drug Abuse, and various and sundry congresspeople.

Monday morning, a Daily Beast columnist weighed in on ending the war on drugs, citing Baum’s article and pointing out that Obama’s talk will take place in a city ravaged by drugs.

Michael Botticelli, director of the White House Office on Drug Control Policy, is among high-level fed officials at Summit.
Michael Botticelli, director of the White House Office on Drug Control Policy, is among high-level fed officials at Summit.

But while the timing is good, a crucial piece of math used in Baum’s interview is probably not only off base but out of the ballpark entirely.

He suggested about 4 million Americans have a drug dependency problem, citing Peter Reuter of the University of Maryland, who Baum said puts the number of people addicted to hard drugs at fewer than 4 million.

What is being defined as a “hard” drug isn’t entirely clear.

But the feds, based on years of national surveys and emergency room data, estimate more than 24 million people are in need of treatment for addiction.

Even if you’re skeptical of figures provided by the federal government’s drug-fighting agencies, consider this: There are an estimated 600,000 or so heroin addicts in the U.S.  Given its lethal dangers, heroin has all the headlines right now, but it is far from the most common drug of abuse.

Think oxycodone, benzodiazepines, Percocet; throw in methamphetamine, and cocaine. For starters.

If even those five drugs generated the same level of addiction as heroin, once you add in the heroin figures you start bumping up against four million number.

Palm Beach Post Reporters Christine Stapleton and Pat Beall  are covering the four-day Summit live from Atlanta.  The two are members of a Post team of reporters investigating scams in Palm Beach County’s $1 billion drug treatment industry.

The 8-month long investigation by the Palm Beach Post uncovered patient brokering, insurance fraud and kickbacks.

Obama to speak at heroin summit: follow Post’s live coverage

Hypodermic needles found in the trash at a cottage apartment by Jean Thomas, 83, in West Palm Beach's Prospect Park neighborhood. (Thomas Cordy / The Palm Beach Post)
(Thomas Cordy / The Palm Beach Post)

President Obama will join high-ranking members of his Administration at the National RX Drug and Heroin Summit in Atlanta this week to discuss ongoing efforts to address the country’s worsening opioid addiction epidemic.

Among other speakers: Michael Botticelli, Director of the Office of National Drug Control Policy; Surgeon General Dr. Vivek H. Murthy; Dr. Tom Frieden, Director of the Centers for Disease Control and Prevention; Dr. Nora Volkow, Director of the National Institute of Drug Abuse; Chuck Rosenger, Acting Administrator of the Drug Enforcement Administration; and Secretary of Agriculture Tom Vilsak.

Palm Beach Post Reporters Christine Stapleton and Pat Beall will cover the event 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

The 8-month long investigation by the Palm Beach Post uncovered patient brokering, insurance fraud and kickbacks. An FBI, multi-agency task force has been investigating the industry for two years. However, no charges have been filed.

The president’s appearance at the Summit on Tuesday follows his visit last year to West Virginia, where he announced a number of new public and private sector actions to address the epidemic, including a Presidential Memorandum on prescriber training and opioid use disorder treatment.

“We are honored that President Obama will participate in the important discussion of combating prescription drug abuse and the heroin crisis,” said Nancy Hale, President/CEO for Operation UNITE, the Summit’s organizer. “His presence will help focus the nation’s attention on the drug epidemic that is devastating families and communities across the country.”

 

 

More vigilante justice: Clean addicts protest outside sober house where three overdosed last week

Young recovering addicts – frustrated with the pace of the investigation of shady business practices in the sober home industry – continued their efforts to crack down on what they say are corrupt sober homes by protesting outside a Lake Worth apartment complex where three addicts overdosed last week.FullSizeRender (8)

“It just takes everyone to get together and not rely on original process,” said R. J. Vied, organizer of the protest outside the apartment where his friend died the Friday night. “We’ve been waiting for authorities to shut them down.”

An 8-month-long investigation by The Palm Beach Post found questionable business practices in the county’s $1 billion drug treatment industry including patient brokering, insurance fraud and kickbacks.

Vied advertised the protest on his Facebook page Saturday morning asking for supporters to join him at the complex on South Federal Highway in Lake Worth. About two dozen young supporters showed up and milled around the complex, which includes a two-story apartment building, small motel and pool. Vied said one young woman moved and and the group helped two others find treatment elsewhere.

A resident of the complex declined to comment, saying his friend had overdosed the night before. While standing on the sidewalk in front of the sober home, one protester spotted a small white bag of white power on the sidewalk. FullSizeRender (7)

The owner of the complex did not return a call for comment. The Post is withholding the address pending comment from the owner.

Saturday’s protest is the second effort in a week by young recovering addicts to take on shady business practices in the sober home industry in Palm Beach County. Earlier in the week, an anonymous recovering addict created a Facebook page named Bill Wilson – the founder of Alcoholics Anonymous – to expose what he described as corrupt operators.

Facebook shut down the page after he outed two sober home operators. However, within hours the anonymous addict created another Facebook page with the same purpose. On Friday he exposed two more individuals. The Post is not publishing the name of the new Facebook page for legal reasons.Bill wilson Redacted

Protesters said they are frustrated that law enforcement and state health officials have not shut down any sober homes or arrested owners and operators despite their complaints. In 2014 an FBI task force began investigating the industry and raided two sober homes. However, no charges have been filed.

“Everybody keeps saying there are going to be indictments but nobody has gotten arrested yet,” said Maureen Kielian, the Florida director of Steered Straight. The longer they wait, the more deaths we’re having.”

Vied, who has been clean and sober for 2 years, said he hoped the protest would show the community that addicts can get clean and are concerned about their perception in the community. He vowed to protest outside a sober home every two weeks.

 

 

Vigilante addicts: Tired of corruption, young addicts point fingers on Facebook

Several hours after Facebook shut down a page created by young, anonymous recovering addicts who vowed to expose what they said were corrupt operators of sober homes in Palm Beach County, the group created another Facebook page on Thursday with the same goal.
Bill wilson Redacted

“WE ARE A LEAGUE OF EXTRAORDINARY MEN AND WOMEN WHOSE PRIMARY PURPOSE IS TO EXPOSE THE FRAUDS OF THE SCUMBAGS WHO ARE PROFITING OFF OF OUR FELLOWS INSURANCE POLICIES,” a member of the group wrote when the page went live on Tuesday.

An eight-month investigation by The Palm Beach Post has revealed questionable practices in the county’s $1 billion drug treatment industry, including insurance fraud, patient brokering and kickbacks. An FBI task force began investigating the industry in 2014. However, no charges have been filed.

The group named its first page Bill Wilson – after the founder of Alcoholics Anonymous – and vowed to expose an operator daily. Dozens of commenters responded – mostly in support of the effort. On Wednesday, the group named a second operator.

By Thursday morning Facebook had taken the page down, saying the content was “abusive.” But by noon the group created another page with a similar name and exposed two more operators.

“I WAS READY TO CALL IT QUITS BUT THE SHOW GOES ON…I FEEL LIKE I LET MY FELLOW ADDICTS DOWN. SO TODAY I WILL BE EXPOSING 2 PEOPLE. SWALLOW YOUR PRIDE AND PUT AWAY YOUR EGO BECAUSE NO ONE IS SAFE, YOU WILL BE EXPOSED!
‪#‎EXPOSED”‬

 

Amid soaring heroin use, Gov. Rick Scott greenlights Florida’s first needle exchange program

Hypodermic needles   found in the trash at a cottage apartment by Jean Thomas, 83, in West Palm Beach's Prospect Park neighborhood. (Thomas Cordy / The Palm Beach Post)
Hypodermic needles found in the trash at a cottage apartment by Jean Thomas, 83, in West Palm Beach’s Prospect Park neighborhood. (Thomas Cordy / The Palm Beach Post)

It’s taken a while- a few years, actually- but today Gov. Rick Scott signed off on a pilot program in Miami-Dade County, run by the University of Miami, which establishes a needle exchange for addicts.

Once politically unthinkable, the state’s soaring rates of IV drug use- and deaths- have slowly made the idea of providing clean needles to addicts acceptable.

Credit the track record of needle exchanges in reducing rates of HIV/AIDS and Hepatitis C. That helps explain why the Florida Medical Association threw its considerable weight behind the pilot program, and why a Republican-led Congress has lifted the ban on using federal money for such exchanges.

Florida’s program is, however, just a pilot. And the University of Miami won’t be able to use state or local tax dollars to get it up and running and keep it going.

But in a written statement, Bill Piper, Senior Director of National Affairs for the Drug Policy Alliance, expressed optimism: “Hopefully this pilot syringe program is just the beginning of major changes in Florida,” he wrote.

Some neighborhoods locally might welcome that: In Prospect Park, 83-year-old Jean Thomas discovered a cache of needles in her trash last year.