The U.S. is the only developed nation experiencing a decline in the opioid crisis. Patrice Harris has been enacting solutions that could be applied in other cities.
Patrice Harris was an early witness to the opioid epidemic in West Virginia, and as an Atlanta resident, she is in close contact with the Centers for Disease Control and Prevention (CDC).
In any case, she has chaired the Opioid Task Force for the American Medical Association (AMA) since 2014. Now as president of the AMA, she travels the country to demonstrate physician leadership on the issue that caused a record 70,000 deaths in 2017 due to drug overdoses —47,000 of which were linked to opioids.
Opioids and suicides — called diseases of despair — have contributed to average life expectancy dropping in the United States for three years in a row. The U.S. is the only developed nation experiencing this decline. Not since the Spanish flu epidemic in the early 1900s has this happened.
Let’s be clear: Physicians were complicit in the erroneous belief that opioids were not much of a threat. That na´ve belief led to prescriptions of opioids when less dangerous painkillers were available.
“This is not a physicians’ problem alone to solve,” Harris told the Florida Times-Union Editorial Board during a recent visit. After all, opioid prescriptions have been slashed since 2012. In fact, a backlash has occurred in which patients with legitimate pain issues are having trouble receiving prescriptions.
Doctors have been warned about abruptly stopping opioid prescriptions for patients with chronic pain. Slow, voluntary reductions of opioid doses can improve quality of life without worsening pain, but this tapering regimen can take years.
“Some folks do benefit from opioids and we hear all the time that pharmacies will not fill prescriptions,” Harris said. “We need to restore some balance here.”
“We are laser-focused on treatment and access to treatment and eliminating barriers for our patients having access to treatment,” Harris said.
The AMA has conducted an 18-month study into best practices for confronting the opioid epidemic. Four states were examined, but not Florida.
In Pennsylvania, the state insurance commissioner’s office evaluates whether parity laws are being used. Mental illness and substance abuse patients are supposed to be treated like any other patients, but that sometimes is not the case.
In a perfect world, what would a successful opioid treatment system look like?
Harris said it would involve a stable, sustainable treatment infrastructure, not chasing epidemic after epidemic.
Vermont built a hub-and-spoke model that provides a treatment network that is both efficient and comprehensive. Patients have access to medical and behavioral services.
Pennsylvania created 45 Centers of Excellence to fill in the gaps for opioid treatment. A designated health center is the hub and the spokes are health care providers, peer recovery specialists and navigators.
The AMA also encourages prescriptions of naloxone for patients at risk of an overdose. This drug can quickly reverse the life-threatening symptoms of an overdose.
Solutions must be local, Harris said. What works in Jacksonville may not work in the Panhandle, for instance.
But it is clear medication-assisted treatment can help transition patients from addictive drugs.