U.S. Attorney General: Cooperation Key to Opioid Fight

Hundreds Attend the MMS Opioid Misuse and Addiction Summit

BY DEBRA BEAULIEU-VOLK
VITAL SIGNS STAFF WRITER
U.S. Attorney General Loretta LynchU.S. Attorney General Loretta Lynch delivered the forum’s keynote address to hundreds of health care leaders, physicians, law enforcement officials, pharmacists, and patients.

As part of her keynote address before the Opioid Misuse and Addiction Summit, U.S. Attorney General Loretta Lynch said collaboration and cooperation among law enforcement and medicine is the key to progress in battling the epidemic of opioid addiction.

“This is a vital public health issue that was for far too long seen only through the lens of law enforcement,” she said before the Oct. 2 gathering, hosted by the MMS and the U.S. Attorney’s office at MMS Headquarters. “As physicians, you see the true human cost of these addictions.”

She described the four points of the White House approach: enforcement, disposal, monitoring, and education. Because prescription drug abuse is a common precursor to abuse of heroin, a federal multi-agency Heroin Task Force will bring a plan to Congress by year’s end, Lynch said.

“We do have reasons for optimism. We can strengthen families and save lives,” said Lynch. “This is about mending the basic fabric of our communities.”

The forum featured a wide variety of experts discussing how to effectively aid patients suffering from addiction and prevent new dependencies from forming. One place to start, experts agreed, is by reducing the amount of prescription opioid medication in our environment.

Many who misuse these pills obtain them not from doctors, but from friends and family members, with and without their knowledge, noted Wilson Compton, M.D., deputy director of the National Institute on Drug Abuse.

Curbing painkiller prescriptions will require a change in the United States’ current “quick-fix culture,” said Massachusetts Attorney General Maura Healey, noting that prescribing of opioids has grown exponentially in the last 15 to 20 years.

DPH Commissioner Monica Bharel, M.D. and opioid panelDPH Commissioner Monica Bharel, M.D. (right), moderates the health care panel discussion of challenges and roles for physicians in addressing the opioid problem.

A physician panel, moderated by DPH Commissioner Monica Bharel, M.D., highlighted the dire need for treatment. “As a frontline physician,” she said. “I’ve been frustrated by the lack of services….When you wheel a patient in for service and there’s no room, there has to be a better way.”

There is a window when people are ready for treatment, but physicians are stymied that treatment is not available, or there’s a weeks-long waiting list. “People die on waiting lists,” said Sarah Wakeman, M.D., leader of an initiative to address opioid addiction at Massachusetts General Hospital. “Treatment works. Most people will recover. We have to keep them alive long enough for them to get treatment.”

Take Advantage of the PMP

Law enforcement officials pointed to the utility of the state’s prescription monitoring program (PMP) as a tool to identify and thwart doctor-shopping. “The tool is right there,” said George Zachos, chief of Medicaid Fraud Unit and Massachusetts assistant attorney general. “If the physicians and pharmacists are using [the PMP] properly, it should never get to us.”

Identifying a potential case of addiction, diversion, inappropriate prescribing, or other misuse is just a piece of the puzzle. Most physicians and pharmacists don’t currently have the tools to take the next step and have difficult conversations with patients, panelists noted.

But simply refusing to prescribe may perpetuate the problem by failing to address underlying addictions or increasing the chances patients will turn to heroin to self-medicate. Rather, experts advised using the opportunity to engage patients and offer or refer treatment for substance use disorders as soon as possible.

There are times, of course, when the benefits of opioid treatment outweigh the risks, and a prescription is helpful and appropriate for the patient. But because so many devastating addictions begin with a legitimate short-term prescription, physicians and pharmacists should be sure not to miss this critical opportunity to educate patients, according to Nancy Coffey of the U.S. Drug Enforcement Administration. Her blunt advice to physicians and pharmacists: “Take the extra 10 seconds to advise patients, ‘This is powerful. Treat it that way. Put it where no one will have access.’”

MMS Public Health Manager Robyn Alie contributed to this report.

Watch more coverage of the forum and read about MMS’s opioid addiction prevention campaign Smart and Safe at massmed.org/opioid-summit.

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