A Conversation Starter

After teaching a CE course on prescription drug abuse in Salt Lake City yesterday, one of the attendees brought up a very intriguing concept while I was leaving. So intriguing that I thought it should be relayed in a broader forum. After laying some groundwork, I'll let you in on the suggestion later.

If you're concerned about the opioid / heroin epidemic, I'm certain you've heard about the letter that U.S. Surgeon General Dr. Vivek H. Murthy recently sent to 2.3 million American health professionals (you can read the actual letter here). There were certainly different perspectives on it in the media (i.e. words matter):

• HHS: United States Surgeon General appeals to America’s clinicians to “Turn the Tide” on the prescription drug epidemic
• CNN: US surgeon general sends warning letter to all doctors on opioid epidemic
• CommonHealth: U.S. Surgeon General Urges Clinicians To Curb Use Of Opioid Painkillers
• CBS: Surgeon general takes unprecedented step amid opioid epidemic

By whatever words you use to describe this action (that I heard him in-person promise to do at the National Rx Drug Abuse & Heroin Summit in April), this is a good thing. The leader of the medical profession in the U.S. has recognized the epidemic and wants to fix it. In the letter, he basically asks the medical community to do three things:

First, we will educate ourselves to treat pain safely and effectively. A good place to start is the enclosed pocket card 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.

The primary focus of this letter is to have the medical profession go to TurnTheTideRx.org and confirm via signing the online pledge that they will deal with this epidemic. "By signing the pledge, you'll also be joining our contact list to stay connected as we #TurnTheTide." Personally. Transparently. Honestly. And foregoing the status quo.

If you want a single resource to understand the issue, I suggest the "Pain Treatment Toolbox" that the Surgeon General has created. Even if you're not a clinician, the resources on this single web page is a great place to start. There are easy-to-understand (and quick to read) graphical fact sheets and concise content to describe the challenges and solutions.

Note this is not a letter to people that are addicted or dependent upon these dangerous drugs. Or to family members or friends that have lost loved ones. Or to community activists who are trying to make an impact. Or to first responders who literally are on the front lines of the life/death battle. Or to the media who reports the deadly statistics and personal stories. Or to Big Pharma or drug cartels. No ... This letter is to the medical profession.

So here's the suggestion ... Let us all hold the medical profession accountable for their response to this outreach by the Surgeon General. If you're an addict, or a patient, or a family member, or a claims adjuster, or a nurse case manager, or a concerned citizen. Ask your doctor whether they've read the letter. Ask your doctor whether they've signed the pledge. Ask your doctor if they've read the CDC guidelines. Ask your doctor what they are doing to help solve this epidemic.

Obviously, many doctors already do the right thing. They will likely gladly sign the pledge because they are already doing the right thing.

For those that aren't yet doing the right thing but want to, this could be the wake up call they need. Signing the pledge and reading the resources will help them make better treatment / prescribing choices and create better clinical outcomes for their patients.

For those that are doing the wrong things for the wrong reasons - and I see stories of these "drug dealers in white coats" often but typically after they've over-prescribed and/or killed their patients - this should be the opportunity to revoke their clinical privileges. If they're not part of the solution, they're part of the problem.

So the next time you talk with a prescriber - doctor, dentist, nurse practitioner, physician's assistant, etal - ask them about TurnTheTideRx. Their answer should be revealing.