Friday night, nearly 100 health professionals, researchers, policymakers and community members gathered with the University of Michigan and Harvard University at the Ypsilanti Marriott Resort at Eagle Crest to discuss research done on the United States’s opioid epidemic. The seven-hour summit, titled “Opioids: Policy to Practice,” featured Rear Admiral Sylvia Trent-Adams, Ph.D., R.N., F.A.A.N. as the keynote speaker. University President Mark Schlissel also gave special remarks as well as commentary from four other panels.
University of Michigan professor of surgery Dr. Michael Englesbe began the third panel on health system approaches to opioid prescription. He explained the vast majority of people suffering from opioid abuse are first introduced to it by doctors and surgeons.
“Particularly disturbing are women who have had breast cancer … (and) survived the cancer, almost 20 percent of those women become chronic opioid users after that horrible journey,” Englesbe said. “It essentially comes down to overprescribing.”
According to a University of Michigan Institution for Healthcare Policy and Innovation brief, prescriptions often far exceed pain management needs and “becoming a new chronic opioid user is the most common post-surgical complication.”
University of Michigan professor of anesthesiology, medicine and psychiatry, Dr. Daniel Clauw, said he was originally trained to not treat chronic pain with opioids. According to Clauw, the industry’s shift came in 1997 when the Food and Drug Administration changed the label for oxycontin and deemed it acceptable for health professionals to prescribe to their patients.
“One of the things that really makes my head explode is when the narrative is driven by these anecdotes, by these patients that are brought up before the FDA … that say they’re on high doses of opioids and that they are doing incredibly well,” Clauw said. “I talk about those individuals that are on very high dosages of opioids that are doing very well. I say, ‘these are like unicorns: I’ve heard about them, but I’ve never seen them.’”
Clauw blames pharmacies for not stopping the distribution of opioids despite knowing the dangers that came along with it. He said they are no less of a cartel than the street traffickers.
“The drug distributors and pharmacies knew exactly what was going on,” Clauw said. “They knew about these drug mules and everything like that, but they were making a lot of money, and they weren’t doing anything to stop this. They even co-opted a lot of our professional organizations.”
In the fourth panel — Public Health Response from Urban to Rural Communities — H. Luke Shaefer, University associate professor of social work, discussed his work with residents from lower income backgrounds around the country and finding solutions to alleviating poverty. He said social determinants — factors such as housing or education that impact one’s overall health — are intertwined with the opioid epidemic.
“Increases in drug-related deaths and opioid prescriptions rates … are both associated with this increase in child homelessness,” Shaefer said.
Shaefer related the story of a woman he encountered and how she suffered from chronic illnesses. He worried about how she would continue to pay for her expensive medications, but more importantly, if her money should be spent on opioids.
Dr. Mary T. Bassett, director of the François-Xavier Bagnoud Center for Health and Human Rights at Harvard University, served as commissioner of the New York City Department of Health and Mental Hygiene from 2014 to 2018 and spent much of her time working on the opioid crisis. She worked with University of Michigan professor of anesthesiology Dr. Chad M. Brummett to curate the summit. Bassett told The Daily in an interview she was pleased with the summit and thought all the research brought forward was exceedingly helpful.
“I really thought it was an incredible alignment across the clinicians, the public health people and the public safety law enforcement,” Bassett said. “Everybody talked about the need for more resources, but there are also a lot of things that can be done without much in the way of resources.”
Brummett was also pleased and hopes policymakers understood the importance of taking action quickly to curb the opioid epidemic.
“I saw common themes from people from multiple backgrounds and multiple areas of specialty, and I hope that our policymakers and our payers heard that, because there are many concepts discussed today that have direct public health implications that can be addressed through better policy,” Brummett said.