Opinion: Opioids are public health crisis of our time

Our nation is facing a severe epidemic: opioid abuse and overdose. This is the public health crisis of our time.

Since 2000, this epidemic has claimed more than 300,000 lives and devastated even more families. Now it threatens to overwhelm communities in our country.

One hundred fifteen Americans die every day from prescription opioids and illicit opioids like heroin and fentanyl. In 2016, drug overdoses killed more than 63,000 Americans – more than 42,000 of these deaths involved opioids – and more recent data showed non-fatal overdoses treated in emergency departments increased by 30 percent from the prior year. Opioid abuse, addiction and overdoses do not discriminate either. The opioid epidemic in our country does not have any geographic, racial, or socioeconomic boundaries.

We must not become numb to these numbers. CDC recently documented a decrease in life expectancy for Americans – for the second year in a row. Each one of these deaths represents the premature end of a precious life worth living and too often cut down in its prime. This is all so heartbreaking, and for me, unfortunately familiar.

More than 30 years ago, America was facing a different deadly national epidemic. AIDS – acquired immunodeficiency syndrome – called on us to make a national commitment to discovery, epidemiologic and therapeutic research, and compassionate care.

I was privileged to be among the early researchers who went to work on the AIDS epidemic. The scientific journey began in urgency to discover and develop effective treatment and preventive strategies. At its peak annual death toll, we lost 44,000 individuals in one year to AIDS.

Thankfully, science has now provided important advancement for both treatment and prevention of HIV infection, such that today the end of the AIDS epidemic in our nation is in sight. Yet tragically, even more Americans are now dying of drug overdoses each year than died from AIDS at its peak.

As I begin my work as Director of the Centers for Disease Control and Prevention (CDC), it is time once again to direct our collective national scientific focus and energies to overcome this new deadly public health crisis.

Since I co-founded Baltimore’s Institute for Human Virology in 1996, our facility has provided HIV treatment to more than 6,000 patients living with HIV infection in the Baltimore-Washington, D.C. community. The evidence-based practice we used to treat HIV complements the prevention approach we now need to prioritize as a nation to more fully confront the scope of the opioid epidemic. We must provide a sound scientific base and rigorous evaluation of current knowledge within the broader strategy of the Trump Administration, and we must always remember that ignorance is the enemy of public health.

Currently, CDC provides funding to 45 states and Washington, D.C., to improve opioid overdose reporting and address prevention activities through enhanced state Prescription Drug Monitoring Programs. These programs provide critical information to health care professionals so they can be aware of the amount of opioids prescribed to their patients, protect patients from an overdose or dangerous medication interaction, and help decrease the potential for diversion or misuse.

CDC also provides up-to-date information about overdoses and other health issues caused by the epidemic, including newborns experiencing opioid withdrawal and infectious diseases resulting from opioid use and misuse, including injected drugs.

States are using this data to speed their public health response. Georgia responded rapidly when a supply of counterfeit pills stamped with a brand name laced with illicit fentanyl was identified in a local hospital emergency department. New Hampshire obtains overdose data from multiple sources — such as public health, law enforcement, EMS — to provide monthly reports on emerging trends, such as upticks in illicit opioid overdoses or county-level hotspots. Timely reporting helps to coordinate and target local action and prevention efforts.

Because all levels of government – local, state, and federal – need the best and most up-to-date data to focus prevention and treatment resources where they are most needed in communities, I am committed to CDC efforts to increase the speed of reporting and achieve data integration with electronic health records and interoperability with health systems. This lets physicians see patients’ prescribing histories using real-time data.

CDC is also deploying tools to promote safer and more effective opioid prescribing for pain management. Recent guidelines now include recommendations for prescribing opioids for chronic pain and interactive online training for healthcare providers. Specifically, CDC focuses both on new providers during their training and continuing education opportunities to ensure that clear evidence is translated into everyday best practices.

Finally, CDC is forging and building on partnerships with law enforcement to address the rise in the use of illicit opioids, particularly fentanyl. Overdose deaths involving fentanyl more than doubled from 2015 and 2016. While law enforcement has continued its focus on stemming the tide of illicit opioids flowing into this country, they have also taken bold steps to partner with community-based prevention and treatment organizations to help keep those suffering from the disease of addiction from entering the criminal justice system.

Our nation has faced tragic epidemics before. Each time, Americans have joined together within families, throughout our communities, and across the government to face these emergencies head-on. We must – and we will – do so again to turn back today’s devastating opioid epidemic.

Dr. Robert R. Redfield is the Director for the Centers for Disease Control and Prevention, and administrator for the Agency for Toxic Substances and Disease Registry.

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