Pubdate: Fri, 05 Aug 2016
Source: Alaska Dispatch News (AK)
Copyright: 2016 Alaska Dispatch Publishing
Note: Anchorage Daily News until July '14
Author: Zaz Hollander


PALMER - Kim Whitaker took the story of her anguish over her 
daughter's ongoing battle with heroin addiction straight to the U.S. 
surgeon general.

Dr. Vivek Murthy was a key participant at a high-powered opioid 
summit convened by U.S. Sen. Dan Sullivan, R-Alaska, at Mat-Su 
College Thursday. The summit aimed to bring federal officials up to 
speed on the challenges Alaska faces in combating heroin and 
prescription painkiller abuse.

Whitaker told about 500 people at the Glenn Massay Theater that her 
daughter became addicted to heroin after a doctor prescribed her opiates at 19.

Then she lost custody of her children. She's been through detox three 
times, twice in Anchorage and the last at home.

Now she's using again.

Whitaker, one of a group of Alaskan women who sparked the summit 
after they shared their addiction stories with Sullivan in 
Washington, D.C., last fall, had a question for the nation's top doctor.

"Is there going to be a unique approach to how we're going to get 
help here because of our uniqueness?" Whitaker asked.

It was the question of the day.

The state's rural areas and lack of treatment facilities can make it 
difficult, or impossible, for some addicts and their loved ones to 
seek care, officials say.

There are only a few dozen detox beds in the state and scant 
treatment options outside Anchorage, Bethel, Fairbanks and other urban areas.

Alaska, like many other states, is in the midst of what medical 
experts categorize as an opioid abuse epidemic over the past decade: 
providers overprescribing painkillers led patients seeking the same 
high to switch to cheaper, more available heroin.

Nationally, 78 people die every day from an opioid-related overdose 
and 580 initiate heroin use, according to Dr. Mary Wakefield, deputy 
secretary of the U.S. Department of Health and Human Services, one of 
the presenters at Thursday's summit.

Thirty-six people died from heroin in Alaska last year, and 83 from 
prescription opioids, according to state data.

Alaska has more veterans per capita than any other state. Veterans 
contend with more pain problems than the general population, 
according to Dr. Jennifer Lee, a deputy undersecretary at the 
Veterans Health Administration. The administration in 2012 launched a 
"safety initiative" aimed at curbing problem painkiller use.

Since 2012, there's been a 25 percent reduction in veterans receiving 
opioid prescriptions, Lee said Thursday.

But a veteran in the audience pointed out the agency still doesn't 
approve the use of medical marijuana to ease off painkillers.

The Rev. Reginald Bright served in Iraq and has been taking opioids - 
he's not addicted, he says - for years. But Bright said he's also 
tried cannabis oil and topical treatments for his aching joints.

"It works great," he said. "The fact of the matter is, getting it is an issue."

Murthy responded there isn't yet scientific evidence marijuana can 
safely and effectively treat medical conditions. The government is 
funding 60 trials and studies now, looking at marijuana's benefits 
and particular harms, he said.

Recovering addicts and alcoholics got immediate cheers Thursday from 
the crowd when they identified the start of their sobriety - 
including Jeff Jessee, CEO of the Alaska Mental Health Trust Authority.

"My name is Jeff and I'm an alcoholic," said Jessee, who serves as 
co-chair of the state's opioid task force. "I have 10 years of 
sobriety. And yes, addiction can happen to any of us and we need to 
end the stigma today."

He told the assembled federal officials that Alaska is already taking 
action on the opioid epidemic with the task force, Medicaid reform 
and a new law that doesn't "overcriminalize" drug use.

But Jessee also had a long list for the feds including staffing 
emergency rooms with substance-abuse professionals, screening 
patients for behavioral health issues and supporting prescription 
drug monitoring programs. He also called for broadening the types of 
providers who can prescribe medically assisted treatment to physician 
assistants and advanced nurse practitioners to increase treatment 
options at rural clinics.

Alaska needs waivers from a federal exclusion that bans facilities 
with more than 16 beds from billing Medicaid, several summit participants said.

Akeela can't collect Medicaid to offer the opioid treatment, said CEO 
Rosalie Nadeau. The Anchorage nonprofit was founded for that purpose 
in 1974, she added.

Akeela's budget is $100,000 lower now than it was in 1992, Nadeau 
said. "I don't know how we continue to serve these people."

Wakefield of HHS said her agency is getting resources for rural 
communities with $9 million in grants, including more than $1.7 
million to Alaska to promote substance-abuse treatment centers. 
President Obama has requested more funding, and Alaska is eligible 
for about $4 million to access treatment, she said.

Alaska's federal delegation participated in Thursday's summit, with 
U.S. Rep. Don Young on video and U.S. Sen. Lisa Murkowski in the 
audience as Sullivan moderated.

Several physicians took less scrupulous peers to task.

"Life is not meant to be pain free," said Dr. Mike Alter, an 
emergency physician at Mat-Su Regional Medical Center who serves on a 
Mat-Su opioid task force. "Opioids are used in ridiculous quantities 
by the medical profession. This needs to be addressed."

Murthy agreed. He said he plans to send a letter to more than two 
million providers calling for action on the topic of painkiller 
overuse - plus a pocket guideline card on treating patients for pain.

Murthy, 39, is traveling the state this week as part of his "Turn the 
Tide" campaign. The focus is engaging with clinicians - doctors, 
nurses, dentists, nurse practitioners - to change prescription 
methods that led to the current epidemic.

The campaign also centers on getting the overdose-reversing drug 
Naloxone to emergency responders, making sure behavioral health is 
part of medical care and educating the public on the roots of addiction.

"Too many people see addiction as a bad choice, a character flaw," he 
said. "It's a chronic disease of the brain."

Murthy spent Wednesday in Bethel, touring a new treatment center but 
also traveling by boat to the Kuskokwim River village of Napaskiak. 
He was impressed to see a teleconferencing setup at the small 
building that houses the clinic.

Murthy said the new Comprehensive Addiction and Recovery Act has 
provisions to help Alaska, including flexibility for providers with 
authority to prescribe medically assisted treatment. He also 
suggested using technology to connect rural clinics with providers in 
Anchorage or the Lower 48.

"The strength of Alaska is far greater than the magnitude of the 
opioid crisis, as great as that is," Murthy said during a lunch break 
press conference.
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MAP posted-by: Jay Bergstrom