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Experts Confront Rx Abuse Epidemic

President Clinton and panelists share personal stories and data to explore solutions.

 

Experts Confront Rx Abuse EpidemicPresident Bill Clinton spoke from the heart at a May 13 town hall meeting at the Bloomberg School, sharing the personal losses that opened his eyes to America’s prescription drug abuse epidemic.

Two years ago, the public health crisis claimed the lives of two young men that he knew. One worked for Hillary Clinton, U.S. Secretary of State at the time, and the other was the son of a neighbor.

“I got involved in this, I’m ashamed to say, from a perspective of total ignorance until a couple years ago. Within a 10-day period, two young men whom I knew, died in their sleep after drinking five or six beers and popping an Oxycontin,” President Clinton said. 

“I wondered how many people are dying, whether from addiction or ignorance,” Clinton said, “and we began to do what we could.”

The town hall, “Prescription Drug Abuse: Evidence Informing Action,” was co-hosted by the Bloomberg School and the Clinton Health Matters Initiative. It included a panel discussion by U.S. Senator Amy Klobuchar; FDA Commissioner Margaret A. Hamburg; Johns Hopkins associate professor Douglas E. Hough; and Patrick J. Kennedy, former U.S. Representative. The panel was moderated by Gail Saltz, Today Show correspondent.

One year ago, the Clinton Foundation announced its prescription drug abuse initiative to cut in half the number of young people ages 18 to 26 misusing prescription drugs for the first time—and save 10,000 lives in three years.

President Clinton said he’s looking to the Bloomberg School for help in applying public health expertise to practical action. He urged experts to develop ways to increase the availability and user-friendliness of the drug Naloxone. “That’s what I’m obsessed with, so if you can help us in that specific way, I would be very, very grateful,” he said. “There are a lot of lives riding on this.”

Following President Clinton's remarks, G. Caleb Alexander,  co-director of the Center for Drug Safety and Effectiveness, recalled his own medical residency training, when he–along with a generation of health professionals–were taught not to worry about the addiction potential of prescription opioids if the patient had true pain. That approach contributed to such soaring opioid use that by 2010, enough opioids were prescribed in the U.S to supply every adult a four-week around-the-clock supply of Vicodin.

Runaway opioid prescribing was only one of the provocative topics taken up during the panel discussion. Hough, a behavioral economist, said our culture finds use of widely available drugs as normal and acceptable. The majority of those using prescription drugs inappropriately get them free from friends or relatives—only 5 percent get them from stranger or drug dealer, he said, quoting CDC statistics.

Senator Klobuchar offered several solutions that are working in her state of Minnesota, which she described as “not only the the land of 10,000 lakes, but also the land of 10,000 treatment centers – and proud of it.” She referred to her own father—a recovering alcoholic who at 87 is still climbing mountains—as an example of the power of good treatment. Klobuchar is also a big believer in drug courts and advocate of prescription drug take-back programs. “We have very limited disposal opportunities for prescription drugs in this country,” she observed, adding that the prevalence of kids addicted to prescription drugs demonstrates the importance of ridding family medicine cabinets of them.

Addressing the all-important mental health component of addiction, former Congressman Kennedy spoke compellingly about systemic fixes based his own experience recovering from opiate addiction: “I would propose a ‘check-up from the neck up.’”  If physicians aren’t paying at least as much attention to their patients’ mental health issues as they are to asthma and cholesterol, then the real cost-drivers in health care today are not being addressed, he said.

While acknowledging the enormous toll of this problem, FDA Commissioner Hamburg spoke of promising scientific and technological approaches on the horizon in terms of deterrents that will reduce the attractiveness and opportunities for abuse of these drugs. “Importantly, we need to recognize that opiates are . . . probably most often not the treatment strategy of first choice. But it may be the option a provider knows best. We need to actively engage with the scientific research community and industry to try to develop new non-opiate non-addictive pain strategies for . . . important pain syndromes.”

The Clinton Health Matters Initiative (CHMI)

Center for Drug Safety and Effectiveness

Johns Hopkins Center for Injury Research & Policy