Pubdate: Mon, 29 Aug 2016
Source: Boston Globe (MA)
Copyright: 2016 Globe Newspaper Company
Author: Vivek H. Murthy
Note: Dr. Vivek H. Murthy is the surgeon general of the United States.


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.

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

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.

Until the full cycle of addiction is accounted for, too many 
recovering addicts will remain at risk.

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 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.

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.

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.
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MAP posted-by: Jay Bergstrom