CDC: Clinicians can play a role in reducing opioid overdoses, abuse
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* Afua Owusu

Approximately 2 million people have reported abuse or nonmedical use of pain relievers in the past year, according to a recent survey.

To address the epidemic, the Centers for Disease Control and Prevention hosted a Clinician Outreach and Communications Activity call on Sept. 24 on the role of clinicians in fighting overdoses.

Loretta Jackson Brown, PhD, RN, health communications specialist at CDC’s Emergency Risk Communication Branch in the Division of Emergency Operations and an APHA member, noted that Substance Abuse and Mental Health Services Administration National Survey on Drug Use and Health, released Sept. 10, reported that there is an increasing trend with the dependence or abuse of heroin.

While there has been a decline in the use of prescription opioids over the past several years, the amount of people abusing prescription opioids is increasing, said Chris Jones, PharmD, MPH, director of the Division of Science Policy in the Office of the Assistant Secretary for Planning and Evaluation at the U.S. Department of Health and Human Services and an APHA member. He referred to the survey and said people who have abused alcohol, marijuana, cocaine and prescription opioids are at greater risk for using heroin. About 75 percent of current heroin users reported using nonmedical prescription opioids before starting heroin, Jones added.

From 1999 to 2013, there were increases of opioid and heroin use among the public. In 2014, 900,000 people reported using heroin in the past year. In 2013, more than 8,000 deaths involved heroin overdose, while more than 16,000 people died due to prescription opioid overdose, according to CDC.

During the call, Jones suggested that preventing people from being exposed to heroin and nonmedical use of prescription opioids could decrease the opioid overdose epidemic. Also, he called for changing how prescriptions are issued to patients and identifying individuals who are at high risk of addiction before prescribing. Jones also suggested guaranteeing medication-assisted treatment and allowing access to naloxone, a drug that reverses the effects of overdose, as a countermeasure for people at high risk of abuse and dependency.

“Pay a lot of attention and talk to your patients you believe to be dependent,” said Gary Franklin, MD, MPH, research professor in the Department of Environmental and Occupational Health Sciences Medicine and Health Services at the University of Washington and medical director of the Washington State Department of Labor and Industries, during the call. “Try to talk to their families as well to see exactly what those patients are doing in their life, how much they’re accomplishing and whether they are basically totally disabled or not.”

Melinda Campopiano, MD, medical officer at SAMHSA’s Center for Substance Abuse Treatment, and Jones both agreed that medication-assisted treatment is effective for both prescription opioid and heroin addiction. Medication-assisted treatment is a comprehensive treatment for opioid use and includes behavioral therapy and case management services for patients, said Campopiano. She also suggested that to be successful, medication-assisted treatment needs to have wide range of options available, such as individualized care and various forms of therapy.

APHA supports implementing prescription drug monitoring programs to help fight the overdose epidemic. Learn more at [www.apha.org/topics-and-issues/prescription-drug-overdose](http://www.apha.org/topics-and-issues/prescription-drug-overdose).

To read a transcript of the CDC call or watch the archived webcast, visit [http://emergency.cdc.gov/coca/calls/2015/callinfo\_092415.asp](http://emergency.cdc.gov/coca/calls/2015/callinfo_092415.asp).

*   Copyright The Nation’s Health, American Public Health Association