Dr. J. Nadine Gracia joins the U.S. Surgeon General in calling on us to lead

Posted on August 25, 2016 by J. Nadine Gracia, MD, MSCE, Former Deputy Assistant Secretary for Minority Health
J. Nadine Gracia

Message from the HHS OMH Director: The Surgeon General is calling on us to lead

Every day, more than 75 people in our country die from a prescription drug or heroin overdose. In 2013, nearly 249 million prescriptions were written for opioids—enough for every adult in America to have a bottle of pills. A significant factor in the opioid epidemic is legally written prescriptions from doctors, dentists, nurse practitioners and physician assistants.

As a physician myself, I understand the important role that we—the doctors, nurse practitioners, dentists and physician assistants of America—can play in the effort to turn the tide on this epidemic. To help address the prescription opioid crisis, U.S. Surgeon General Dr. Vivek Murthy is taking historic action by sending a personal letter to more than 2.3 million health care practitioners and public health leaders. I want to make sure you see his letter, a copy of which I have included below. Please take a moment to read it and then visit www.TurnTheTideRx.org to join with clinicians from across the country in a simple but powerful movement to end this epidemic.

TurnTheTideRx.org provides clinicians with practical tools, information, and in-the-trenches stories from colleagues offering their insights into the epidemic. This new resource becomes another crucial tool in our work to reduce the behavioral health disparities that minorities experience, including lack of access to services and treatment. Some of these barriers to care include systemic issues of bias in the health care delivery system; discrimination; lack of insurance; and cultural, language, and communication barriers between patients and providers.

For the communities we serve at the HHS Office of Minority Health, we are for example concerned by the prescription opioid overdose deaths among American Indian/Alaska Native (AI/AN) populations–death rates that surpass those of non-Hispanic whites according to data from the CDC. And while AI/AN populations have the highest prescription opioid deaths rates of all Americans, the devastation of this epidemic is felt across all populations, including all racial and ethnic minority populations. Now is the time to shine a light on the hidden realities of mental and substance use disorders in communities of color—conditions that are often intensified by trauma. And, lack of health coverage and the ability to afford care are often reported as barriers to seeking treatment, further compounding the disparities generated by adverse social and economic conditions.

The HHS Office of Minority Health, along with Dr. Murthy, encourages you to spread the news about this new effort to combat the prescription opioid crisis to your networks and communities. We hope you will join the movement and be a part of the solution. Together we can turn the tide.

J. Nadine Gracia, MD, MSCE, is the Former Deputy Assistant Secretary for Minority Health and Director, Office of Minority Health, U.S. Department of Health and Human Services

About Turn the Tide Rx Turn the Tide Rx is a national campaign created to enable “prescribers talking to prescribers.” Turn the Tide Rx aims to educate prescribers about the opioid epidemic, mobilize health care professionals to improve prescribing practices, provide the public with information to protect themselves and their families from opioid misuse and overdose, learn from communities around the country that are finding creative ways to tackle the opioid epidemic, and change the cultural perceptions around addiction so that it is not seen as a moral failing but a chronic illness that must be treated with skill, urgency and compassion.

UNITED STATES SURGEON GENERAL

Vivek H. Murthy, M.D., M.B.A.

August 2016

Dear Colleague,

I am asking for your help to solve an urgent health crisis facing America: the opioid epidemic. Everywhere I travel, I see communities devastated by opioid overdoses. I meet families too ashamed to seek treatment for addiction. And I will never forget my own patient whose opioid use disorder began with a course of morphine after a routine procedure.

It is important to recognize that we arrived at this place on a path paved with good intentions. Nearly two decades ago, we were encouraged to be more aggressive about treating pain, often without enough training and support to do so safely. This coincided with heavy marketing of opioids to doctors. Many of us were even taught – incorrectly – that opioids are not addictive when prescribed for legitimate pain.

The results have been devastating. Since 1999, opioid overdose deaths have quadrupled and opioid prescriptions have increased markedly – almost enough for every adult in America to have a bottle of pills. Yet the amount of pain reported by Americans has not changed. Now, nearly 2 million people in America have a prescription opioid use disorder, contributing to increased heroin use and the spread of HIV and hepatitis C.

I know solving this problem will not be easy. We often struggle to balance reducing our patients’ pain with increasing their risk of opioid addiction. But, as clinicians, we have the unique power to help end this epidemic. As cynical as times may seem, the public still looks to our profession for hope during difficult moments. This is one of those times.

That is why I am asking you to pledge your commitment to turn the tide on the opioid crisis. Please take the pledge. Together, we will build a national movement of clinicians to do three things:

First, we will educate ourselves to treat pain safely and effectively. A good place to start is this pocket guide with the CDC Opioid Prescribing Guideline. Second, we will screen our patients for opioid use disorder and provide or connect them with evidence-based treatment. Third, we can shape how the rest of the country sees addiction by talking about and treating it as a chronic illness, not a moral failing.

Years from now, I want us to look back and know that, in the face of a crisis that threatened our nation, it was our profession that stepped up and led the way. I know we can succeed because health care is more than an occupation to us. It is a calling rooted in empathy, science, and service to humanity. These values unite us. They remain our greatest strength.

Thank you for your leadership.