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Barack Obama, Dan McGinn and a Big Idea

I had the honor of attending the program in Charleston headed by President Barack Obama and native West Virginian Sylvia Matthews Burwell, U.S. Secretary of Health and Human Services, last week. West Virginians and the President discussed the issue of opioid drug dependence and the unacceptable – and avoidable -- death rate from overdoses. Drug overdoses now are the leading cause of accidental death in America, accounting for more deaths than car accidents.

That is staggering!

Dan McGinn, in his Op/Ed piece in the Gazette-Mail, suggested that we address two big problems in health care – drug addiction and obesity. These are two big issues in health care that require big ideas.

The problem is not easy.

I have blogged before about the critical role that addressing the economic and educational challenges found in West Virginia have on our health issues. But, as was evidenced in Charleston, deaths from prescription opioid and heroin overdose are crossing communities from poor to rich; from underprivileged to privileged; from broken homes to stable homes. There are no lines here – all families are open to the pain that emanates from a young person suffering a preventable death.

The President used a great analogy: you care about the fire department putting out the fire at your neighbor’s house so that the fire will not spread to yours. The same reasoning exists with approaching drug use.

The solution is multidimensional.

We at WVU have an important role to play, in collaboration with others across our state. We’re building a foundation for our work in partnership between the WVU Injury Control Research Center, (funded by the CDC and led by Dr. Jeff Coben)  with the Comprehensive Opioid Addiction and Treatment program (COAT) led by Dr. Rolly Sullivan in our department of Behavioral Medicine.

They’ll work side by side with experts from pain management, behavioral medicine, policy, infectious diseases, and pharmacy.

Our goal will be to look at the supply and demand side of the equation. Ideally, our great preference will be to predict which people are at highest risk for addiction and intervene before they start. This approach should heavily focus on our children.

As we heard in Charleston, we also need to open more slots to take care of addicted patients with insurance coverage to pay for help. We also need to provide access to life-saving naloxone/narcan, which blocks the impact of the narcotics on receptors in the brain. This medication will reverse the effect of drug overdoses on the breathing center, which is the most frequent cause of death in these patients. Many people across the state are working together to get this into the hands of first responders and family members of drug users.

I suggested on Hoppy Kercheval’s radio show after the President’s visit that doctors and pharmaceutical companies are largely to blame for this epidemic. While I stand by this statement, I also feel that many doctors were operating out of a sense of helping, as it was taught not many years ago that doctors undertreated pain. In fact, pain was at one point talked about as the fifth vital sign.

A single paragraph letter to the editor in the New England Journal of Medicine was often cited as the evidence that narcotics like Oxycontin would not cause addiction.

Well, it does. And many are addicted.

This is the opportunity for us to go first and address this straight on. This is a problem not only for West Virginia, but for the country.

It is time for us to stand up and lead and make West Virginia the beacon for the country.