Aspen Ideas takes sobering look at opioid addiction
The United States is at risk of falling further behind dealing with an opioid addiction crisis, which already kills 91 people per day on average, former U.S. Surgeon General Vivek Murthy said Friday in Aspen.
Murthy, who served under President Obama from 2014 to 2017, said the healthcare bill crafted by Senate Republicans would end coverage for an estimated 20 million people. As a concession to senators from states hard hit by the opioid crisis, the bill also proposes to spend $2 billion annually for addiction treatment.
“That is absolutely insufficient,” Murthy said during a panel discussion at the Aspen Idea Festival’s Spotlight Health.
He was on the panel for a program called, “The Opioid Tsunami.”
Murthy said many people struggling with opioid addiction are also facing other medical and mental issues. Ending their treatment for those core issues could ultimately trigger increased opioid use.
“We have 50,000 people who have died from drug overdoses in 2015,” Murthy said, “and over 60 percent of those are from prescription opioids.”
Opioids are prescription medications and elicit drugs such as heroin that act on receptors in the brain to diminish pain and, sometimes, cause euphoria.
Opioids are a legitimate part of doctors’ toolbox to treat acute and chronic pain, the panel members agreed, but their use exploded in the 1990s. Some pharmaceutical aggressively marketed opioids as a safe and non-addictive painkiller in the 1990s. Insurance industry practices favor prescribing pain medication over more time-consuming and costly integrated care.
Cheap heroin rolled into the U.S. to replace more expensive prescription opioids. Now, drug runners are using highly concentrated and deadly synthetic opioids such as fentanyl and carfentanil, which have surfaced in the Roaring Fork Valley.
Yasmin Hurd, a professor of psychiatry, neuroscience and pharmacological sciences at Mount Sinai Health System, said the synthetic opioids are particularly addictive because they affect the brain and leave the body so quickly.
“Even if you are not at high risk, taking those will definitely take you over the edge,” Hurd said.
Opioid addiction is piling up.
“We have come to a place where we have more 2.5 million people who are addicted to opioids,” Murthy said. “We have about 1.9 million who have an opioid use disorder that involves a prescription of painkillers and a little over 600,000 who have a disorder involving heroin.
“We have 12 million people who are misusing these opioids. They may not have a full-blown substance use disorder yet, but they’re at risk of that,” he said.
“That’s why coverage is so important,” Murthy said. “This should not be a partisan issue.”
An overflowing crowd at the Koch Tent at the Aspen Meadows saw sobering snippets from the new HBO documentary “Warning: This Drug May Kill You” during the discussion.
Documentary maker Perri Peltz showed excerpts that demonstrated how the crisis has crossed socioeconomic lines, making shambles of the lives.
HBO got interested in exploring the epidemic two years ago as drug overdose deaths became prevalent in many parts of the country.
“The narrative at the time was it was bad kids abusing good drugs that were intended for pain patients,” Peltz said. “What we learned is that’s just not the case.”
The vast majority of people she met went to heroin after they became addicted to prescription painkillers. The documentary attempts to change the perception from an abuse problem to an addiction problem.
Peltz showed the opening scenes of the documentary, which show victims of opioid overdoses walking or sitting like zombies, in many cases toppling over and becoming unresponsive. Many people in the crowd gasped at the scene of a young mother sprawled on the floor of a grocery store, her toddler crying and pulling on her arm to try to revive her.
“For too long, too many of us have been saying, ‘This is somebody else’s problem. It’s not our problem. It’s not going to happen to me,’” Peltz said. “The fact of the matter is it’s happening to a lot of people — our parents, our children, our cousins and our friends, and we really wanted to show what that looked like.”
The panel members agreed that the key to ending the opioid crisis is overcoming the stigma that addiction is a weakness and abuse that could have been preventable. It’s a disease, they said.
The treatment must be longer than a three-month program at a center. It must be ongoing and deal with key issues that lead to addiction, they said.
And medical care must start dealing differently with pain rather than relying on prescribing drugs.
“We have numbers that are quite staggering, but what has really been striking to me is the stories behind those numbers,” Murthy said. “What you see when you go out and meet people who have struggled with opioid addiction is this is a truly devastating illness. It’s one that tears people’s lives apart, it destroys families and it weakens communities.”
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