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According to data available published by the Centers for Disease Control and Prevention (CDC) we lose 115 Americans each day to an opioid overdose. Further since 1999 the CDC reports over 400,000 Americans have died of an opioid overdose. As glum and startling as these numbers are, it does not tell the full story of the many millions of individuals and families who live with opioid use disorder each day, and the negative impact that has on so many people and communities across our nation.
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As much as we might like to offer solutions to this catastrophic and growing healthcare crisis, there does not appear to be a silver bullet which will end this epidemic any time soon. The next best alternative is to identify steps which can be taken that may move things in the right direction. To that end, I will propose five actions which can be carried out by individuals, communities, healthcare organizations, and government entities.
- Opioid Use Disorder is a chronic disease, so let’s end the stigma and shame. We need a grass-roots and broad-based campaign to inform and educate that opioid use disorder is a chronic lifetime disease like diabetes, hypertension, and so many others that are treated as medical issues. This campaign will first inform that opioid use disorder is a disease which needs and deserves medical treatment. Next it will communicate that those individuals and families who suffer are not alone in their battle, and there is no reason to be ashamed if you or a loved one is struggling with opioids. Then, it will let those interested know that there are treatment methods, such as medication-assisted treatment, available to help, and inform them on the next steps.
- Create a new normal by educating doctors, dentists, and other prescribers that they need to get smarter about the highly addictive nature of opioids, and to provide patients with pain management alternatives. We need to establish a “new normal” to manage all pain, but particularly non-cancer chronic pain, which does not include opioids as the first or only step. This campaign will also educate the general population that doctors and other prescribers are not experts when it comes to either the addictive nature of opioids or pain management alternatives, and patients need to start the conversation in many cases. We our need our prescribers to have a new normal that will first explore, communicate, and provide opioid alternatives to manage pain that pose less risk–such as physical therapy, acupuncture, etc.
- Tell the truth about those in the pharmaceutical industry who lied about opioids and addiction. This campaign would tell the truth about how many Americans have died or developed a chronic disease because of the misrepresentations of various pharmaceutical companies. Building on the very successful anti-cigarette “truth” campaign, which tapped into adolescent rebellion, the goal here is to create rebellion against the bad actors in the pharmaceutical industry who placed profits over people’s lives.
- Get waivered / save a life. This campaign would target doctors and other prescribers to convince them to get waivered so they can prescribe the life changing and life-saving drug buprenorphine. Today only three percent of prescribers who write opioid prescriptions are waivered for buprenorphine, and this limits access to this highly effective treatment. This must change.
- Get naloxone / save a life. This campaign would target families with members who suffer from opioid use disorder. The message is simple: Carry naloxone and you may save the life of someone you love.
Francis Melaragni is an associate professor at the Massachusetts College of Pharmacy and Health Science in Boston.