Constructive Tone Carries Through Summit Session

A constructive tone defined the opening plenary session of the Rx Drug Abuse & Heroin Summit on Monday in Atlanta.

U.S. Rep. Harold “Hal” Rogers advocated for the use of drug courts and the development of workforce training as a pair of strategies to reduce recidivism. Admiral Charles W. Ray, vice commandant of the U.S. Coast Guard, championed collaboration between federal agencies and a strengthening of the Coast Guard’s capacity for cracking down on transnational drug organizations. Robert R. Redfield, MD, director of the Centers for Disease Control and Prevention stated his goals for making high-quality data more timely. And Elinore McCance-Katz, MD, PhD, assistant secretary for mental health and substance use, spoke on the need to bring addiction treatment training into the mainstream for all healthcare practitioners.

‘In the thick of the fight’

Rogers said that even as data shows opioid overdose deaths have begun to plateau, fentanyl, heroin and cocaine overdoses have the addiction treatment field “still in the thick of the fight.”

Rogers noted that next month marks the 30th anniversary of the establishment of the nation’s first drug court, and said that moving forward, he would like to see an increased focus on workforce training to help those in recovery find jobs and restart their lives on the right foot.

Rogers also presented the Congressman Hal Rogers Beacon of Hope to John L. Eadie, coordinator of the Public Health and Prescription Drug Monitoring Program Project, National Emerging Threat Initiative, National HIDTA Assistance Center. Rogers credited Eadie for his extensive work in bringing prescription drug monitoring programs to the forefront, hailing him “a Paul Revere for PDMPs.”

Efficient data

Redfield shared a pair of goals CDC is working toward: Reducing US drug overdose mortality by at least 15% by 2021 and making opioid-related data available more efficiently, reducing the delay for data on nonfatal opioid overdoses from three months to one week.

Detecting trends in opioid overdose-related emergency room visits will provide opportunities for action in addressing the epidemic, Redfield said. He also noted the effectiveness of prescription drug monitoring programs nationwide. In particular, he said PMDPs have helped reduce per capita opioid prescribing by 85% in Ohio, 80% in Florida and 62% in Kentucky. Meanwhile, patients’ practice of seeing multiple prescribers has been cut down by 75% in New York and 36% in Tennessee thanks in part to PDMPs.

Looking ahead, Redfield said there will be three keys for attendees: improving the linkage to care, continuing to destigmatize drug use, and improving the support provided for families and communities.

“Ending this epidemic is, in fact, very possible. Working together will do just that,” he said.

MAT and medical withdrawal

McCance-Katz spent a healthy portion of her presentation discussing medication-assisted treatment. She said there should be “no artificial limits” placed on the length of time a patient engages in MAT, adding that treatment should continue for long as it is beneficial.

McCance-Katz added that for patients who go through detoxification, or medical withdrawal, there is relapse rate of greater than 80% in the year following treatment, and that the risk for overdose-related death is high. Patients who request medical withdrawal treatment should also be provided with injectable naltrexone, she said.

“It’s the right thing and ethical thing to do,” said McCance-Katz.

Coast Guard’s crackdown

Ray shared the U.S. Coast Guard’s philosophy on cracking down on the entry of illicit substances into the United States by created “a forward-based presence” 1,500 miles to the south. Over the past three years, the Coast Guard, along with its interagency partners, has seized 1.4 million pounds of cocaine, and delivered 1,800 smugglers to the U.S. justice system, Ray said.

Still, he said, there is room for growth. Ray said Coast Guard intelligence is capable of tracking an estimated 80% of drug-related assets moving across the seas south of the U.S., but the Coast Guard’s fleet of six ships patrolling the area are capable of seizing about 20% of those assets.