Wednesday, November 30, 2016

Lt. Gov. Ralph Northam meets with Carilion leaders to discuss opioid addiction and its challenges

Carilion Administrative Conference Room

Carilion Administrative Conference Room

Virginia’s Lieutenant Governor Ralph Northam, a pediatric physician, started off the discussion Wednesday morning with a chilling statistic – there have been 860 deaths so far this year due to opioid overdoses. Virginia is on par to reach 1000 deaths by year end he said.

Dr. Northam, met with leaders at Carilion Roanoke Memorial Hospital to discuss the opioid public health emergency and to highlight policy solutions he will push for in the 2017 General Assembly session and beyond.

Nancy Agee, President and CEO of Carilion Clinic

Nancy Agee, President and CEO of Carilion Clinic

Steve Arner, President/CEO, Carilion Medical Center, Nancy Agee, President and CEO of Carilion Clinic, Dr. William “Bill”  Wasserman, Vice President of Psychiatry, Dr. John Burton, Chair of the Department of Emergency Medicine, and Dr. Thomas R. Milam Co-interim Chair of the Department of Psychiatry were joined by 8 other leaders all grappling with the opioid health emergency.

All praised State Health Commissioner Dr. Marissa Levine’s standing order that allows all Virginians to obtain the drug Naloxone, which can be used to treat narcotic overdoses in emergency situations.

The standing order serves as a prescription written for the general public, rather than specifically for an individual, removing a barrier to access.

Virginia opioid addiction crisis declared a Public Health Emergency

Dr. Wasserman said the opioid health emergency was a call to action. “Patients and families are suffering.”

Addiction is a progressive disorder. When patients can’t get opioids from their physician anymore they often turn to heroin.

All spoke of needing a collaborative effort, populace education, funding, treating the homeless and the financial challenges of charity care.

“We minister to them as best we can. Getting insurance to pay for detox is a challenge,” said Dr. Milam.

“Alcohol withdrawal is life threatening; heroin is not.”

Steve Arner, President/CEO, Carilion Medical Center and Lt. Gov. Ralph Northam

Steve Arner, President/CEO, Carilion Medical Center and Lt. Gov. Ralph Northam

Lt. Gov. Northam said funding is needed so people don’t get turned away. Dr. Milam said identifying the pockets of vulnerable patients was crucial.

Youth as young as 13 and 14 were getting infectious diseases from reusing needles to administer heroin. The reuse of needles increases the cases of hepatitis C. It is almost becoming an epidemic.

Northam said the conservative general assembly rejects providing clean needles to prevent disease. “The issuance of needles is just condoning [the behavior] they say. They don’t want to fund it,” said Northam.

“When the heroin problem is on the rise you have a crime problem on the rise. Virginia is very much behind the times.”

Virginia does a good job at policing physicians who are prescribing opioids but there is no testing with a   license renewal said Dr. Milam.

Prescribing habits for pain need to be revised and education on how to appropriately prescribe opioids needs reinforcing. “I recognize the problem. We don’t like our patients to be in pain,” said Dr. Milam.

See Prescribing Opioids for Chronic Pain put out by the Center for Disease Control (CDC) – HERE.

Emphasis is also needed on adhering to the prescription monitoring program as not all physicians have signed up for it.

Virginia’s new upgraded prescription monitoring program went live Wednesday and all physicians who do not use the system are encouraged to sign up.

Rehabilitation efforts from opioid and heroin use only has about an 8% success rate. That leaves 92% who stay in treatment.

There’s much to gain from coordination between pharmacies. There needs to be a transition from volume to value.

Physicians struggle with the definition of success with many addicts remaining in rehab and/or on methadone.

Ideas to combat opioids included returning unused pain medication to pharmacies though the cost for pharmacies to manage a program would probably be cost prohibitive. Adults locking up medications to keep them from their children is low hanging fruit.

Lt. Gov. Northam said that the opioid emergency will take a lot of funding and resources. The farther west you go in the state you find that shopping for opioids across state lines becomes a common problem.

An interview with Dr. John Burton, Chair of the Department of Emergency Medicine will expand on Carilion’s new pain management program. Look for it soon.

Posted By Valerie Garner

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