Opinion

Opinion | Dr. Vivek H. Murthy

Turning the tide on opioid addiction

Sherri Smith held an early photo of her twin sons, Jesse and Tony Sparks, both of whom died from accidental drug overdoses.
John Hart/Wisconsin State Journal/AP/File 2016
Sherri Smith held an early photo of her twin sons, Jesse and Tony Sparks, both of whom died from accidental drug overdoses.

RECENTLY I MET a man in Phoenix who told me that being diagnosed with cancer had made him happy. “How could this be?” I asked him. He told me having cancer meant he would likely need surgery, which in turn meant more prescriptions for the pain pills to which he had become addicted. He had started using prescription painkillers when he was young. Over the years, addiction hijacked his brain, compromising his health, altering his reasoning, and leaving broken relationships and deferred dreams in its wake.

Nearly 2 million people in America are addicted to prescription painkillers, also known as opioids. Every day, 41 people die from a prescription opioid overdose — a four-fold increase since 1999. In the same time period, the amount of prescription opioids sold in the United States has also quadrupled, with no improvement in the overall pain Americans report. Prescription opioid addiction is now contributing to increased heroin use and the spread of HIV and hepatitis C.

We arrived at this place on a path paved with good intentions. Nearly two decades ago medical professionals were encouraged to be more aggressive about treating pain, often without enough training and support to do so safely. This coincided with heavy marketing of opioids to doctors. Many of us were even taught — incorrectly — that opioids were not addictive when prescribed for legitimate pain. The results have been devastating.

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The opioid epidemic has now become one of the nation’s most urgent public health threats.

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For the last four months, as part of my “Turn the Tide” campaign, I have been visiting areas hard hit by the opioid epidemic — from cities in Tennessee to villages in Alaska. I have met teachers, elected leaders, executives, and homeless residents who are rebuilding their lives because they were able to access and stay in treatment. Unfortunately, right now we have the capacity to provide treatment for just one million people. There are more than one million people with opioid addiction who need treatment but can’t get it. We have to close that gap.

I also have met with thousands of medical professionals to discuss how we can treat pain more safely and effectively. These clinicians expressed a desire to be part of the solution — and we need them to be. That is why I took the unprecedented step of sending a letter to 2.3 million health care practitioners, urging them to join the movement we are building to end the opioid epidemic and to pledge their support at TurnTheTideRx.org. That letter is arriving in mailboxes over the next few days.

As much as health care practitioners have an obligation to act, they can’t address this crisis alone. The opioid epidemic can only be solved if all of us step up to do our part. So what can we do?

First, we must recognize that prescription painkillers are addictive. That doesn’t mean they should never be used. Sometimes they are the right solution. But they should be used with caution. Talk to your doctor about safer alternatives to opioids, including non-opioid pills, physical therapy, and cognitive behavioral therapy.

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Second, if you fill a prescription for opioids, store them in a secure location. Often the worst place to keep your pain medications is the medicine cabinet. For many people, especially children and teenagers, experimenting with medications that belong to family members and friends is how their opioid addiction begins. Never share your medications with others, and properly dispose of your pills when you no longer require them.

Third, we must change how we see addiction — not as a moral failing, but as a chronic disease. Too many people with addiction are afraid to ask for help because they are worried they will be judged. We have to encourage, not discourage, new treatment centers in our communities so people can get help. We have to treat addiction with the same skill, urgency, and compassion with which we would treat diabetes or heart disease.

We have an opportunity to turn the tide on the opioid epidemic in America. We must focus on prevention by educating clinicians and the public. We must expand access to treatment by funding programs that are proven to work. We must invest in developing safer alternatives to opioids and better technology to support doctors who are treating pain.

The Obama administration has already taken action on a number of these fronts and has asked Congress for an additional $1.1 billion to combat the opioid epidemic. These resources will provide much needed support to expand treatment and are urgently required.

The man I met in Phoenix was fortunate to find a good opioid treatment center. He was blessed to have doctors, counselors, and family members who never gave up on him. After many months of hard work, he is now in recovery and has a job helping others struggling with addiction.

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As challenging as this epidemic is, I believe we can overcome the opioid crisis in America. But we can only do so if we move away from blame and recognize that all of us are vulnerable. In the battle against addiction, compassion is our most powerful weapon. It’s what allows us to stop judging and to start helping. It’s what enables us to look past our biases and our differences to work together on fashioning the solutions that millions in America urgently need.

Dr. Vivek H. Murthy is the surgeon general of the United States.