Trump declares opioid epidemic public health emergency

Photo illustration by Michel Maulding.
Photo illustration by Michel Maulding.

President Donald Trump and the Department of Health and Human Services declared the opioid epidemic a national public health emergency Oct. 26, taking action against the growing drug problem that took almost 60,000 American lives last year.

Gov. Terry McAuliffe declared the epidemic a public health emergency last year. According to the Virginia Department of Health, 803 Virginians died last year from fentanyl and/or heroin and 465 died from a prescription opioid overdose.

Assistant Vice President of Health Sciences for Interprofessional Education and Collaborative Care at Virginia Commonwealth University, Alan Dow, said the administration’s announcement is a first step to addressing the crisis.

“Really the big thing the government can do at the federal level is provide directed funding to help will clinical programs or training programs or other parts of local government response,” Dow said. “The public health emergency is going to shift some funding priorities around and so we’ll have to see what that means to our local area in terms of where does that money move from and what does it move towards.”

Dow said there are two problems underlying the crisis: addiction and substance abuse, and undiagnosed substance abuse disorders.

According to NPR, about 150 Americans die every week from overdoses of heroin, fentanyl and other opioids. Administration officials have been questioned over the designation of the opioid crisis as a public health emergency rather than a national emergency.

“Everyone who I’ve met who has a substance abuse disorder wants to become abstinent. There might be things related to addiction that may be keeping them from doing it but people that have substance abuse disorders want help,” Dow said. “And a lot of those people are part of chronic pain treatment programs and so their addiction is manifesting as chronic pain management and so we need to do more to be able to understand what’s underlying people’s chronic pain.”

FEMA can declare national disasters for situations like hurricanes and other natural disasters. Health and Human Services declare emergencies in the event of infectious diseases or poisonings. The administration’s response is that the designation will allow greater efforts on a nationwide basis, shifting resources directed towards HIV/AIDS care to also include substance abuse.

Jenny Fox is a pediatrician in the Neonatal Intensive Care Unit at the Children’s Hospital of Richmond at VCU.

Fox said she knows the opioid crisis affects all walks of life. Her team manages infants with in utero opioid exposure leading to Neonatal Abstinence Syndrome or NAS. NAS is a group of problems that occur for newborns who have been exposed to opiates while in the mother’s womb.

“I encourage any women of childbearing age with an opioid addiction to seek help and counseling as early as possible,” Fox said. “The message I want to get across is that as healthcare providers, our intention is to help these women get care for themselves and their infants.”

Omar Abubaker is an oral surgeon and professor of dentistry at VCU. Abubaker was personally touched by the epidemic, when he lost his 21-year-old son, Adam, in 2014. His son was prescribed Vicodin following a shoulder injury in high school and then became addicted to heroin. Abubaker now serves as an advocate and educator in the efforts to end the epidemic.

“I lost my son and I wish I knew what I know now because there’s a possibility I could have saved him,” Abubaker said. “I wish I knew that the prescription that he got was harmful and potentially addictive, I would have just took them away and had him try something different.”

Pres. Trump said his plan would require federally employed prescribers of opioids to be trained in safe practices, in addition to a new federal initiative to create non addictive painkillers. He also spoke of increasing efforts to block shipments of fentanyl, an inexpensive and powerful synthetic opioid made in China that has invaded the United States.

Abubaker supports many of the recommendations made in the President’s Commission on Combating Drug Addiction and the Opioid Crisis. He hopes the national declaration will come with increased education on the national level, create access to addiction and mental illness treatment and to naloxone — a drug used to block or reverse effects of opiates. In 2016, Virginia issued an order allowing anyone to buy naloxone without a prescription.

According to the Center for Disease Control and Prevention “overdoses from prescription opioids are a driving factor in the 15-year increase in opioid overdose deaths. The amount of prescription opioids sold to pharmacies, hospitals, and doctors’ offices nearly quadrupled from 1999 to 2010.”

The National Institutes of Health estimates about 80 percent of heroin users started with prescription pain medication.

Abubaker recognizes the medical community’s role in the epidemic and works to educate himself and his students on appropriate pain management prescriptions. He said he used to prescribe 20-30 pills for opiates like  Hydrocodone or Oxycodone. Now, he writes them for only five or six pills.

“The medical community did not intend to be part of the problem. They are looking for the good of the patients so what they thought was if the patient is in pain then they need pain medication and opioid is the best pain medication,” Abubaker said. “The pharmaceutical companies and the leading experts on pain management mislead doctors and said Oxycontin and Oxycodone are not addictive.”

Abubaker wants to see science of addictions, the opioid epidemic, pain management and mental illness in the greater medical curriculum. In addition, he wants to see practitioners educated on evidence based prescribing and pain management.

“I think it’s getting better even here at VCU, the changes in the curriculum. It’s already taking place in the medical school, at the residency level and some at the dental school,” Abubaker said. “If I save one parent who says I’m not going to give my son this Codeine or this Vicodin because I heard Dr. Abubaker say this is not good for you and that kid doesn’t get hooked, that would be worth all of the effort I do.”

SaraRose Martin, Staff Writer

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