15 December 2016

U.S. Surgeon General Calls for Action on the Opioid Crisis

Opioid abuse remains a devastating public health concern, and the health care community has grappled with its role in the crisis and medical professionals’ responsibility to patients struggling with substance use. U.S. Surgeon General Vivek Murthy has responded with a report released last month analyzing the current opioid crisis and providing several recommendations for treating and preventing substance use disorders. These recommendations include:

1. Eliminate stigma

Misconceptions and negative judgments about people with substance use disorder abound, and the report stresses that even medical professionals are not immune to seeing addiction as a “moral failing or character flaw.” Murthy’s report states that substance use disorder is a medical problem, and that as such doctors should lead a cultural shift in thought through advocating for medicine and counseling treatment for affected patients.  

2. Provide effective screening

Along with its goal of changing societal perceptions of addiction, the report calls for changing the health care system’s process for identifying substance use disorder. Effective screening must occur in general health settings, including primary, psychiatric, and emergency care centers. With this change, physicians can identify affected patients earlier and create individual treatment plans for them.

3. Make use of medication

One of the many misconceptions about the opioid crisis is the assumed futility of medical treatment – it is essentially seen as “substituting one substance for another,” so abstinence is believed to be the best treatment plan. Murthy’s report extensively disputes this belief, asserting that using approved medicines within a broader behavioral therapy plan can help treat substance use disorder.

4. Involve an integrated medical team

Ultimately, Murphy’s report declares that effective substance use treatment plans must involve an integrated team of social workers, recovery specialists, nutritionists, and other caregivers. As with programs designed for diabetes or cancer treatment, all aspects of the affected patient’s life must be considered to address and treat the disorder.

Programs to Aid in the Fight Against the Opioid Crisis

Many patients first encounter opioids during the surgical period. As the nation’s largest anesthesia provider, Sheridan is piloting several initiatives aimed at combating the opioid crisis by reducing the opportunity for exposure. 

  • Sheridan anesthesiologists and their surgical colleagues are piloting ERAS (enhanced recovery after surgery) programs, using a combination of non-steroidal anti-inflammatory agents and specialized regional nerve blocks with local anesthetics to optimize recovery and minimize narcotics use. 
  • We are also preparing to pilot pre-operative pharmacogenetic testing next year. Not only will this testing help anesthesiologists tailor medication based on a patient’s genetic data, thereby minimizing negative drug reactions, but it will also help identify patients predisposed to narcotic addiction. For these patients, Sheridan physicians can find pathways for treatment using limited to no opioids during the perioperative period. 

Our goal is to gather and share data on the effectiveness of these programs to help enrich the health care community’s efforts to stop the opioid crisis.