Dr. Vivek Murthy, Surgeon General takes on opioid use in US

“How we respond to this crisis is a test for America”

Surgeon General Dr. Vivek Murthy issued an unprecedented letter to doctors and other medical professionals on November 15 asking for their help to solve the United States’ devastating opioid epidemic.  “The opioid epidemic is one of the most pressing public health crises we’re facing,” Murthy told The Huffington Post. “My hope is that we can mobilize clinicians around the country to join the national movement we’re building to turn the tide on the opioid epidemic.”

“The issue of addiction affects everyone regardless of political party,” race, ethnicity or socioeconomic status, he said, adding that the effort to combat the drug epidemic has been bipartisan. The urgency to address addiction is only growing,” Dr. Murthy said. He vowed to continue his work to “change how we’re talking about addiction and get people to step forward and ask for help.”

The new report said that 78 people die every day in the United States from opioid overdoses, a number that has nearly quadrupled since 1999. It estimated that the annual economic toll related to alcohol is $249 billion and that the toll related to drugs is $193 billion.

The majority of people who misuse substances do not develop a use disorder, the report said. But roughly one in seven Americans — 14.6 percent of the population — are expected to develop such a disorder at some point.

Only about 10 percent of people with a substance use disorder receive any type of specialty treatment, the report said. And while more than 40 percent of people with such a disorder also have a mental health condition, fewer than half receive treatment for either.

From 40 percent to 70 percent of a person’s risk for developing a substance use disorder is genetic, the report said, but many environmental factors — like how old he or she is when first drinking or trying drugs — can influence the risk.

People who first drink alcohol before age 15 are four times more likely to become addicted at some time in their lives than are those who have their first drink at age 20 or older, the report said.

Nearly 70 percent of those who try an illicit drug before the age of 13 develop a substance use disorder within seven years, the report said, compared with 27 percent of those who first try an illicit drug after the age of 17.

“The deaths caused by prescription drug, heroin and fentanyl overdoses are growing exponentially every year, yet this report fails to provide any detailed road map for how best to curb opioid addiction,” Senator Edward J. Markey, Democrat of Massachusetts, said in a statement. The magnitude of the opioid epidemic, he said, “demanded a far more detailed discussion.”

In addition, the report comes at the tail end of the Obama administration, which pleaded unsuccessfully with Congress this year for $1 billion to fight the opioid epidemic. Congress instead set aside $181 million, a move that a disappointed President Obama said was better than nothing.

In his letter, Murthy noted that 2 million people in American have a prescription opioid use disorder, an unprecedented level of addiction that’s contributed to both increased heroin use and the spread of infectious diseases such as HIV and hepatitis C. He noted that prescriptions for opioids have skyrocketed disproportionately to chronic pain levels. The epidemic is also increasingly deadly: Opioid overdose deaths have quadrupled since 1999.

In addition to the letter itself, the surgeon general’s office launched a website called TurnTheTideRx and issued an opioid prescribing pocket card for health care providers about how to treat patients who are in pain. Murthy encouraged health care providers to sign a pledge to educate themselves about treating pain safely and effectively, to screen patients for opioid use disorder, to connect them with evidence-based treatment, and to talk about and treat addiction as a chronic illness.

“In combination, our hope is that these will help clinicians to shape their practice and be part of the solution when it comes to addressing the opioid epidemic,” Murthy explained. Doctors started the opioid epidemic, and they can help solve it. Still, Murthy thinks that if doctors helped fuel the epidemic, they can help stem it, too.

At 37 years old, physician, public health advocate, entrepreneur and grassroots organizer Vivek Murthy is one of the youngest U.S. Surgeon Generals in our nation’s history, and the first one of Indian descent. Prior to his confirmation, he was a physician at Brigham and Women’s Hospital and a Hospitalist Attending and Instructor in Medicine at Harvard Medical School. He was President and cofounder of Doctors for America, a national grassroots organization of 15,000 medical students and physicians advocating for high-quality and equitable health care. In 2011, Dr. Murthy was appointed by President Barack Obama to serve on U.S. Presidential Advisory Council on Prevention, Health Promotion and Integrative and Public Health. Dr. Murthy is also cofounder of TrialNetworks, Epernicus and VISIONS.

“It’s time to change how we view addiction,” Dr. Vivek H. Murthy, the surgeon general, said in releasing the report. “Not as a moral failing but as a chronic illness that must be treated with skill, urgency and compassion. The way we address this crisis is a test for America.”