opioids

BALTIMORE. Public Officials of the Year: Leana Wen, Health Commissioner, Baltimore

By Mattie Quinn

Leana Wen never had her sights set on public office. She was happy working as an emergency room doctor and lecturer in medicine in Washington, D.C. And when the position of Baltimore health commissioner came open, in 2014, she was only 31 years old. But a widely respected former commissioner urged her to apply for his old job, and she decided to go for it. 

There was no way Wen could have imagined what she was about to get into. Just a couple of months after she moved into her new post in Baltimore, riots erupted in the city following the death of Freddie Gray, an unarmed black man, in police custody. Wen leveraged the unrest to start a conversation about police brutality and poverty as public health issues. “If we care about our children and their education,” she said, “we should also care about lead poisoning in their homes. If we care about public safety, we should also address mental health and substance addiction and the huge unmet need there.”

Born in Shanghai to a family of Chinese dissidents, Wen emigrated to the U.S. when she was eight and grew up in Compton, south of downtown Los Angeles. She graduated college at 18 -- summa cum laude from California State University -- and then went on to become a Rhodes Scholar at Oxford, held a clinical fellowship at Harvard, and wrote a book called When Doctors Don’t Listen.

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NATIONAL. President Trump’s Says He Wants to Stop the Opioid Crisis. His Actions Don’t Match (TIME)

By Dr. Mary T. Bassett, Dr. Julie Morita and Dr. Barbara Ferrer 

Dr. Mary T. Bassett is the Commissioner of Health for New York City, a position she assumed in February 2014. With more than 30 years of experience in public health, Dr. Bassett has dedicated her career to advancing health equity.

Dr. Julie Morita was appointed as commissioner of the Chicago Department of Public Health (CDPH) in early 2015; under Dr. Morita’s leadership, CDPH developed and launched Healthy Chicago 2.0, a four-year plan to assure health equity by addressing the social determinants of health.

Dr. Barbara Ferrer leads the Los Angeles County Department of Public Health which protects and promotes health and prevents disease among L.A. County’s more than 10 million residents. Dr. Ferrer has over three decades of experience as a philanthropic strategist, public health director, researcher, and community advocate.

President Trump’s declaration of opioids as a public health emergency left jurisdictions across the country – including New York City, Los Angeles and Chicago, the cities and county we serve as health commissioners and director – scrambling to understand the actual impact that this legal action will have on our response to an alarming increase in drug overdose deaths. In our cities, 2,650 people died last year of a drug overdose, the largest number on record.

Given the public health emergency designation, answers to three basic questions will determine the significance of this action: How much funding for public health responses will states and cities actually be able to access to support a long-term response to this deadly epidemic; how those dollars can be used; and for how long new funds will be available.

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NATIONAL. Drug, HIV crises hit HHS nominee Price close to home

By Meredith Wadman Dec. 2, 2016

Representative Tom Price (R–GA), the physician and congressman who is Donald Trump’s nominee to head the Department of Health and Human Services (HHS), represents a wealthy suburban district just north of Atlanta that is regularly ranked by Forbes and others as one of the best places to live in the country.

But Price’s district is also experiencing some public health crises that he will likely be dealing with as HHS secretary: a serious heroin and opioid abuse epidemic, as well as elevated HIV infection rates.

The heroin problem was described in great detail in this investigative special by the local NBC affiliate 11Alive, which aired in March.  The narrator introduces the multipart series with the following stark facts:

“Just north of Atlanta, heroin is killing more of our young people than violent crime. Atlanta’s most affluent area is dealing with a nearly 4000% increase in heroin-related deaths over the past 5 years.” She names as particular problems towns including Alpharetta, Roswell, and Johns Creek—all in the heart of Price’s district.

Data released this week by the Big Cities Health Coalition Project further flesh out the picture. It shows Fulton County—which takes up a chunk of Price’s district, as well as much of the city of Atlanta—with a higher rate of HIV diagnoses in 2013 and of accidental deaths from opioid overdoses in 2014 than all but one of 28 cities studied.

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KANSAS CITY. Kansas City’s killers: guns, pills and cigarettes (Kansas City Star)

BY SCOTT CANON

scanon@kcstar.com

Kansas City has a thing for drugs, guns and smokes.

And that’s killing us.

Data released Tuesday comparing cities on various measures of public health showed Kansas City residents more likely than those elsewhere to drop dead from drugs in the heroin family, to get injured or killed by firearms or to die from lung cancer.

The numbers released by the Big Cities Health Coalition compared 28 cities on measures ranging from cancer deaths to binge drinking. (Fewer Kansas Citians tend to get drunk than those in other cities.) The database covers the largest cities in the country defined by the population within their city limits. That leaves out some large metro areas, such as St. Louis. And not all cities reported data in every category.

Largely drawn from city health departments, the numbers showed deaths from opiates in Kansas City at 15.7 for every 100,000 people — or more than three times the national average.


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BOSTON. Providing A Safe Space And Medical Monitoring To Prevent Overdose Deaths (Health Affairs Blog)

Jessie GaetaBarry Bock, and Mary Takach

August 31, 2016

According to the Centers for Disease Control and Prevention (CDC), more people died from drug overdoses in 2014 than in any year on record. Most of these deaths—78 every day—involved an opioid. Closer to home in Boston, deaths from opioid overdoses increased by 50 percent from 2014 to 2015 (Note 1). In our practice, Boston Health Care for the Homeless Program (BHCHP), based on the corner of Massachusetts Avenue and Albany Street (the epicenter of Boston’s drug activity), opioid overdoses have become the leading cause of death among our patients.

Overdoses were happening multiple times each week in our lobby, clinic bathrooms, and on the sidewalks and alleys adjacent to our building. Despite significant existing services aimed at the prevention and treatment of substance use disorders (SUD), we were not effectively engaging some of the highest-risk people with SUD. There was recognition among our staff, board of directors, and patients that in addition to improving screening for SUD, expanding access to opioid agonist therapy, broadly distributing naloxone (the rescue drug to reverse opioid overdoses), improving opioid prescribing practices, and expanding housing opportunities, we also needed to reduce the harms associated with ongoing drug use and provide a safe alternative to the street for people who are over sedated. Our goals are to respond with a new service that:

  1. Prevents fatal overdose;
  2. More effectively connects highest-risk individuals with addiction treatment; and,
  3. Addresses the impact of SUD on our patients, our organization, and our neighborhood.

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NATIONAL. US House passes opioid legislation package, which now heads to Senate (McClatchy)

Tony Pugh, McClatchy Washington Bureau

WASHINGTON — The House of Representatives overwhelmingly passed a bill Friday to help fight heroin and prescription opioid abuse after Democrats dropped a demand that the measure include nearly $1 billion for drug treatment services.

The legislation, which was crafted by a joint House-Senate committee, now goes to the Senate next week, where Democrats must decide whether to approve it even though President Barack Obama might not sign it into law because of a lack of funding.

Currently, the Comprehensive Addiction and Recovery Act authorizes nearly $200 million for a variety of programs aimed at curbing prescription opioid and heroin abuse. But Congress must appropriate the money at a later date.

Earlier this week, White House press secretary Josh Earnest said Obama might not sign the bill if no funding was attached.

The legislation passed 407-5 on Thursday with lawmakers from both parties supporting the bill in a rare show of election-year bipartisanship.

The bill would provide resources to expand opioid prevention and educational efforts and to increase the availability of the overdose-reversal drug naloxone for police and first responders. The measure strengthens programs to monitor and track opioid prescription trends and boosts efforts to identify and treat incarcerated addicts...

Public health officials dealing with a national increase in drug addiction were cautiously optimistic, despite Senate Democrats' unease with the bill's lack of funding.

Chrissie Juliano, director of the Big Cities Health Coalition, which represents 28 large public health departments, called the legislation a "first step" but said more money was needed.

"We look forward to working with congressional leaders in the coming days to find a way to ensure robust funding to accompany their response," she said in a statement.

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