To U.S. Surgeon General Jerome Adams, the 2.1 million Americans with opioid use disorder represent more than a pressing national health crisis.
It’s a personal one too.
Adams’ younger brother, Phillip, struggled with untreated mental illness for years and eventually turned to substances to self-medicate, the surgeon general said at a June 26 event at The Pew Charitable Trusts in Washington.
Phillip Adams began using tobacco and alcohol, then marijuana, until “one day at a party someone gave him a pill,” a prescription opioid, the surgeon general said. Phillip is now serving a 10-year prison sentence for stealing $200 to support his addiction.
Adams says he tells Phillip’s story to combat what he calls “the biggest killer” in the country: stigma.
“Stigma keeps people in the shadows, keeps people from asking for help, and keeps people like my brother from recognizing that he has a problem,” he said. “We have to share stories to turn around the crisis that we’re in.”
Adams believes that stories like the one he tells about his family can help reduce the stigma of addiction. “We can use the opioid epidemic, and the fact that people are now talking about it, as an opportunity to see what can we do to prevent this from happening in the future. Then we’ll see health improve across the country,” he says.
Almost 48,000 Americans died from opioid overdoses in 2017—an average of 130 lives lost each day, according to the Centers for Disease Control and Prevention. But these deaths do not tell the full story about substance use disorder. Individuals who misuse drugs or alcohol are more likely to develop chronic health conditions, experience poorer health outcomes, and have contact with the criminal justice system. The costs of the national epidemic are high: The National Institute on Drug Abuse estimates that illicit drug and alcohol misuse accounts for more than $400 billion in annual spending related to health care, lost productivity at work, and crime.
A crisis of this magnitude provides what Adams calls “a tremendous opportunity.” He told the audience: “We’ve got to really break down traditional silos and really reach out to folks who haven’t been to the table.” He advocates forming partnerships with law enforcement, the military, the medical and business communities, faith leaders, and local officials to reduce the number of people suffering and dying from opioid addiction, and to prevent future health care crises.
Pew’s substance use prevention and treatment initiative develops and supports state and federal policies to prevent substance misuse and improve treatment options for people with substance use disorder.
Adams also said, “we’re not going to turn around the opioid overdose epidemic unless more people are willing to carry naloxone.” The surgeon general issued an advisory in April 2018, the first from that office in 13 years, that urges more Americans to carry the Food and Drug Administration-approved medication that can reverse the effects of an opioid overdose. More than 2.7 million double doses of naloxone have been distributed since the advisory.
The medication is the first step to getting individuals struggling with opioid use disorder into critical care, Adams said. “A person dies every 11 minutes of opioid addiction. They’re not dying in alleys—they’re dying in homes, bathrooms, in kitchens,” he said. “We’re not going to overturn the opioid epidemic unless more people carry naloxone.”
Adams showed the audience at Pew how to use naloxone, which works like a nasal spray, by shooting some into the air. (It also can be administered by using an auto-injector with a retractable needle).
Getting individuals into treatment is key to combating the crisis, Adams said, citing the need to pair them with peer recovery coaches and medication-assisted treatment—a combination of behavioral therapies and FDA-approved drugs—to put them on the path to long-term recovery.
Pew’s initiative also “encourages states to expand access to medication-assisted treatment, which has proved to be the most effective therapy for opioid use disorder,” Susan Urahn, Pew’s executive vice president and chief program officer, said when she introduced Adams.
Adams stressed the need for better partnerships and for reaching out to members of diverse communities to tackle the epidemic. “We all need to walk the talk,” he said, urging the audience to get naloxone. “We can’t get people into recovery if they’re dead.”