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As many of you know, the opioid epidemic has resulted in the loss of too many lives.  While heroin was once the drug that was the scourge of many inner cities, the rampant use and abuse of powerful painkillers has impacted many living outside of major cities. Surgeon General Jerome Adams provides some facts about opioid usage and how to help those in the midst of addiction.

WHAT ARE THE RESPONSIBILITIES OF THE U.S. SURGEON GENERAL?

As America’s Doctor, my primary job is to advance and promote the health of the American people. I do that by sharing the best scientific information so that individuals and communities can improve their overall health. I also lead over 6,500 officers of the U.S. Public Service Commissioned CorpsMy motto as Surgeon General is “better health through better partnerships.” I feel strongly that we must forge new partnerships with non-traditional partners, including businesses, law enforcement, and the faith-based community.

WHO WERE YOUR ROLE MODELS AND WHO INSPIRED YOU TO GET TO WHERE YOU ARE TODAY?

I had severe asthma when I was younger. During my medical encounters, I noticed none of the doctors who cared for me  looked like me. The first time I ever interacted with a Black physician was in college when I had an opportunity to meet Dr. Ben Carson.

To see a Black man making such important contributions to the field of medicine gave me hope, and a belief that I could do the same. Today only six percent of all physicians are Black – a number which is disproportionately low for our community.

That’s why representation matters. It mattered to me back then, as a young college student with a budding interest in science, and it matters now for my kids and every other young boy or girl who we want to inspire to dream big.

Black History Month is an opportunity for us to reflect upon our achievements, honor our role models, and reinforce hope to that young child that they, too, can make a difference.

WHAT IS AN OPIOID?

Opioids are a class of drugs originally developed to treat pain.

Common opioids prescribed are Oxycodone, OxyContin, Hydrocodone, Vicodin, Morphine, and Methadone. These drugs can be helpful for a short time but they have serious risks, most notably the risk of addiction. Therefore, it is important to have a conversation with your doctor about your pain, and if and how prescription opioids are part of a plan that is right for you.

Fentanyl is an especially strong type of opioid. Fentanyl can also be illegally made and is extremely dangerous. We have seen a significant increase in illegally made or obtained Fentanyl in several states.

Heroin is also an opioid. It is never available by prescription. Heroin is illegal and extremely addictive. When people inject heroin, they are at risk of serious, long-term diseases such as HIV, Hepatitis C, and Hepatitis B, as well as bacterial infections of the skin, bloodstream, and heart.4

WHY ARE YOU FOCUSING ON THE OPIOID EPIDEMIC?

Science tells us that addiction impacts every community in America. An estimated 2.1 million people in the U.S. struggle with an opioid use disorder.[1] Unfortunately only 1 in 5 receives any form of treatment.[2]

Even more troubling, every 12.5 minutes, we lose someone to an opioid overdose.[3] This is unacceptable and we need to do more. This issue is personal for me.  My brother is currently in prison. He has struggled with addiction for years and, like many others in his predicament, his addiction is a key factor in his history of incarcerations.

 HOW DOES IT IMPACT THE BLACK COMMUNITY?

The opioid epidemic does not discriminate – people of all colors are dying.  However, there is a substantial impact on racial and ethnic minorities and disadvantaged populations.  Studies show that there were disproportionately large increases in drug deaths among racial and ethnic minority groups in the last year.

African-Americans experienced an increase of 58% in opioid deaths between 2015 and 2016.

And in 2016, Black and African-American youth 12-17 were more likely than whites to have used opioids in the past year. This alarming data shows that we are moving in the wrong direction, and may be a precursor to even more opioid overdose fatalities in the Black community in coming years.

We must all be vigilant and ensure that prevention messaging is reaching our young people. Communities also need to know that effective, evidence-based treatments are available to treat opioid use disorder. The earlier you intervene, the better outcome you are likely to achieve.

WHAT ARE YOU DOING ABOUT IT?

As the Surgeon General, I am focused on educating the American people about the severity of the opioid crisis.  That starts with putting Naloxone – a medication that can reverse the effects of an opioid overdose-  in the hands of police officers, firefighters, paramedics, and community members.

I am also working to educate the public about the severity of the epidemic, and working with our communities to destigmatize addiction. I want people to know that addiction is a chronic disease and it must be treated with skill, compassion, and urgency.

Finally, we must prevent addiction before it starts.  That is why I am working with health care professionals to improve safe prescribing practices.  We want to help patients understand the benefits of opioid alternatives as well as understand how to safely dispose of and store prescription opioids.

WHAT CAN PEOPLE DO TO HELP SOMEONE WHO MIGHT BE ADDICTED TO OPIOIDS?

First, it is important to have a conversation. I know this may be a difficult conversation to have, but there are resources available. You can find these resources here. Second, you should learn the signs of an opioid overdose, like pinpoint pupils, slowed breathing, or loss of consciousness.

Third, if you know someone who is at risk—taking high doses of prescription opioid medication for chronic pain, misusing prescription opioids or using illicit opioids — then you can be prepared by carrying and knowing how to use the overdose-reversing medication, Naloxone.  It is safe, easy to use, widely available, and can save a life. To learn more, visit here.

Fourth, if you are taking prescription opioids, store your prescriptions in a safe place and dispose of them properly. As with all medications, you should only take medications as prescribed to you by your doctor.

Fifth, it is important to know that treatment works and people recover every day. Research shows a combination of medication, counseling and behavioral therapy can help people achieve long-term recovery.  Encourage your family member or friend to receive treatment.  You can call the Substance Abuse and Mental Health Services Administration’s (SAMHSA) National Helpline 1-800-662-HELP (4357) or go to https://www.findtreatment.samhsa.gov/ to find a treatment center.

WHAT TYPE OF PROFESSIONAL RESOURCES ARE AVAILABLE TO SOMEONE WHO IS ADDICTED TO OPIOIDS?

It is important to know effective treatment is available. For opioid use disorder, the gold standard is the use of medication in combination with ongoing behavioral therapy, also known as Medication Assisted Treatment, or MAT.

If you are referring a patient, friend, or family member to care, be an informed consumer and make sure they are going to a reputable provider.

Here’s what you should look for in a treatment center:

  • Personalized diagnosis, assessment, and treatment planning – one size does not fit all and treatments should be tailored to you and your family
  • Access to FDA-approved medications.
  • Effective behavioral interventions delivered by trained professionals.
  • Long-term disease management – addiction is a chronic disease of the brain with the potential for both recovery and recurrence. Long-term outpatient care is the key to recovery.
  • Coordinated Care for other/co-occurring diseases and disorders.
  • Recovery support services – such as mutual aid groups and community services that can provide continuing emotional and practical support for recovery.

[1] Center for Behavioral Health Statistics and Quality. 2015 National Survey on Drug Use and Health: detailed tables. Rockville, MD: Substance Abuse and Mental Health Services Administration; 2016

[2] Center for Behavioral Health Statistics and Quality. 2015 National Survey on Drug Use and Health: detailed tables. Rockville, MD: Substance Abuse and Mental Health Services Administration; 2016

[3] CDC. Drug Overdose Deaths in the United States, 1999–2016

[4] Centers for Disease Control and Prevention, Vital Signs: Today’s Heroin Epidemic; 2015

Dr. Adams answers your ‘Text Tom’ questions below:

Q: What about medical marijuana as alternative to opioid prescriptions?

A:The Federal Government has and continues to fund research on possible health benefits of marijuana and its components. While clinical trials for certain components of marijuana appear promising for some medical conditions, neither the Food and Drug Administration nor the Institute of Medicine have found smoked marijuana to meet the standards for safe and effective medicine for any condition to date.

Q: I’m on Tramadol. Is this addictive?

A: Tramadol is an opioid. All prescription opioids can be helpful for a short time but, they also all have serious risks, most notably the risk of addiction. Therefore, it is important to have a conversation with your doctor about if, and how, prescription opioids are part of a plan that is right for you.

For more information on opioids, including Tramadol https://www.cdc.gov/drugoverdose/data/analysis.html

Q: Are there alternative pain medications for people with sickle cell anemia?

A: There are alternative pain management options for a number of diseases, including sickle cell.  It is important to have a conversation with your doctor about your pain, and if and how alternative pain modalities are right for you.

For more information, visit https://www.cdc.gov/ncbddd/sicklecell/index.html

Jerome M. Adams, MD, MPH, the 20th Surgeon General of the United States, was sworn into office by Vice President Mike Pence on September 5, 2017. Dr. Adams, a board-certified anesthesiologist, served as Indiana State Health Commissioner from 2014 to 2017. Dr. Adams, a Maryland native, has bachelor’s degrees in both biochemistry and psychology from the University of Maryland, Baltimore County, a master of public health degree from the University of California at Berkeley, and a medical degree from Indiana University School of Medicine.

Dr. Adams was also an associate professor of clinical anesthesia at Indiana University School of Medicine and a staff anesthesiologist at Eskenazi Health, where he was Chair of the Pharmacy and Therapeutics Committee.  He has served in leadership positions at a number of professional organizations, including the American Medical Association, the Indiana State Medical Association and the Indiana Society of Anesthesiologists. He is the immediate past Chair of the Professional Diversity Committee for the American Society of Anesthesiologists.

As Health Commissioner, Dr. Adams presided over Indiana’s efforts to deal with the state’s unprecedented HIV outbreak.  In this capacity, he worked directly with the Centers for Disease Control and Prevention, as well as with state and local health officials and community leaders, and brought the widest range of resources, policies and care available to stem the epidemic affecting that community.

He also helped with the successful launch of Indiana’s state-based, consumer-driven alternative to Medicaid expansion and worked with the state legislature to secure more than $10 million to combat infant mortality in high-risk areas of the state.

Dr. Adams’ motto as Surgeon General is “better health through better partnerships.” As Surgeon General, Dr. Adams is committed to maintaining strong relationships with the public health community and forging new partnerships with non-traditional partners, including business and law enforcement.

He has pledged to lead with science, facilitate locally led solutions to the nation’s most difficult health problems, and deliver higher quality healthcare at lower cost through patient and community engagement and better prevention.

As Surgeon General, Dr. Adams oversees the operations of the U.S. Public Health Service Commissioned Corps, which has approximately 6,500 uniformed health officers who serve in nearly 600 locations around the world to promote, protect and advance the health and safety of our nation and our world.

 

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