The opioid epidemic in America has emerged as one of our nation’s most urgent public health threats. Every day in America, 41 people die from a prescription opioid overdose. Nearly two million Americans suffer from prescription opioid use disorders, which are 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, clinicians 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 doctors were even taught– incorrectly –that opioids are not addictive when prescribed for legitimate pain. Since 1999, opioid prescriptions have increased markedly– enough for every adult in America to have a bottle of pills. Yet the amount of pain reported by Americans has not changed.
As a doctor caring for patients over the years, I have seen the impact of opioid addiction on individuals and their families. As Surgeon General, I have seen that the opioid crisis does not discriminate– it affects everyone from teachers to students, parents, to people of all income levels in urban and rural America alike.
In response to this public health threat, my office launched the “Turn the Tide” campaign earlier this year. A key area of focus for the campaign is working with health care practitioners to improve prescribing practices and connect people to treatment. As I have visited areas of our nation hardest hit by the opioid epidemic, from cities like Boston and Knoxville to remote villages in Alaska, I have found doctors and other clinicians eager to do their part.
In August, I took the unprecedented step of sending a letter to 2.3 million health care practitioners, urging them to join the national movement we are building to end the opioid epidemic and to pledge their support at TurnTheTideRx.org.
In the last few weeks, thousands of people from across the country have responded to this call to action and have signed the pledge. And many more are joining their colleagues and fellow clinicians every day. To help them out, we’ve created a guide on how to prescribe opioids that fits nicely in the pocket of a doctor’s coat.
To turn the tide, we must all do our part– not only medical professionals and people living with opioid use disorders – but also community leaders, business owners and members of the public.
First, we must all recognize that prescription opioids are addictive. That doesn’t mean they should never be used. Sometimes they are the right solution. But they should be used with caution. Patients should talk to their doctor about safer alternatives to opioids, including non-opioid medications, and non-medication options such as physical therapy, and cognitive behavioral therapy, where appropriate.
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. I have heard accounts of children and teenagers experimenting with medications that belonged to family members and friends. 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 living with opioid use disorders are afraid to ask for help because they are worried they will be judged. We have to encourage, not discourage, more clinicians to provide substance use treatment in our communities so people can get the help they need. We have to treat those with opioid use disorder with the same skill, urgency, and care with which we would treat diabetes or heart disease, and follow the evidence just as we do with chronic diseases.
In addition to the steps individuals must take, we as a society must invest more in expanding treatment. Right now there are more than 1 million people with opioid use disorders who need treatment but can’t get it. We have to close that gap.
The Obama administration has already taken action on a number of these fronts, including requesting an additional $1.1 billion from Congress to ensure people with opioid use disorders who are seeking treatment can get the care they need. That investment would build on our efforts to expand access to the overdose-reversal medicine naloxone, promote evidence-based prevention programs, and improve opioid prescribing practices.
As challenging as this crisis may appear, we can overcome the opioid epidemic in America. But we can only do so if we remember that, in the battle against addiction, compassion is our most powerful weapon. It’s what allows us to stop judging and start helping. Ultimately, compassion is what will enable us to come together to save lives, strengthen our communities and end the opioid epidemic.
Learn more about the opioid epidemic at www.hhs.gov/opioids.