Panel, Fireside Chat, Conference Presentation
A State of Emergency: Integrative Approaches to Addiction and the Opioid Epidemic
Milken InstituteDavid Beier, Jerome Adams, Terry McAuliffe, Lori McFarling, Tom Moriarty, Nora Volkow, Tammy Wincup
- Economic projections indicate a $64 return for every dollar invested in prevention, while Governor McAuliffe anticipates that expanding drug courts will save hundreds of thousands of dollars per individual compared to the $24,833 cost of incarceration per prisoner.
- Discovery Education expects to have engaged over one million students since launching "Operation Prevention" in September 2016 and plans to invite partners like the National Association of Secondary School Principals to pledge resource sharing within an open-source model that requires no financial sponsorship.
- CVS plans to expand its drug take-back program to 750 locations by the end of the next year, having already removed over 100 metric tons of unwanted pharmaceuticals in the last two years, and aims to extend the "One Choice Program" to back-to-school nights to educate over 300,000 students via pharmacists.
- Caremark, a CVS subsidiary, plans to institute a seven-day limit on first fills for plan sponsors starting in February to reduce oversupply, while CVS has implemented counseling on "first fills" for acute pain to encourage disposal of unused medication.
- Dr. Volkoff notes a 22 percent increase in overdoses from 2015 to 2016 resulting in 64,000 deaths, warning that reversing the crisis requires a paradigm shift in prescribing to avoid leaving legitimate pain patients undertreated.
- Dr. Collins expects immediate structural healthcare changes are necessary to reimburse physicians for comprehensive pain management treatments and anticipates public-private partnerships will accelerate the development of safer, effective analgesic medications.
- Governor McAuliffe reports that Virginia reduced over-prescriptions of morphine-related drugs by a third (from 942 to 610) in the last six months and expects to continue leading on reducing buprenorphine abuse, which has dropped by 35 percent in the state.
- The Surgeon General plans to issue a report on health in the economy to demonstrate that communities lacking social capital suffer disproportionately during crises, while expecting a new assistant secretary for mental health and substance abuse to coordinate federal efforts.
- Dr. Levine expects identifying and mitigating Adverse Childhood Experiences (ACEs) is critical, noting one positive adult influence can build resiliency, while Dr. Collins anticipates providing alternative behaviors to children is required to prevent distress.
- The moderator anticipates leveraging real-time data from sewer microbiome testing to identify heroin and fentanyl flare-ups for immediate law enforcement intervention and expects tech companies to utilize AI and social media for education.
- Governor McAuliffe reports that 46 of 50 governors signed a data-sharing compact and expects the government to leverage granular prescription data from industry players like CVS and Express Scripts to close public-private partnerships for real-time sharing.
- Governor McAuliffe expects that failing to address the opioid crisis will hinder economic growth in renewable energy and other sectors, as able-bodied workers cannot participate in the workforce in regions that have lost coal, textile, furniture, and tobacco industries.
- The Surgeon General anticipates that statistically one out of eight children who try pills found in a relative's cabinet will become addicted, hoping individual actions like clearing medicine cabinets before Halloween, Thanksgiving, and Christmas will break addiction pathways.
- A panelist observes the educational climate is overcrowded, noting teachers cannot absorb new half-hour interventions without displacing core curriculum, prompting a plan to embed "Operation Prevention" into existing math, science, and social studies resources.
- Dr. Volkoff expects agencies will not revert the surge in substance use disorder, and Dr. Collins anticipates that without replacing opioids with alternatives, existing disparities in pain management access will return.
- The moderator expects the session to provoke new ideas regarding the opioid crisis and anticipates discussing the role of pharmacists, who polls rank near the top of most respected professions alongside doctors and nurses.