Never before has a U.S. Surgeon General sent a letter to every doctor in America, but that changed on Thursday when Dr. Vivek Murthy wrote to nearly 3 million doctors asking “for your help to solve an urgent health crisis facing America: the opioid epidemic.”
As National Pain Report has extensively covered, the government has placed the lion’s share of blame for overdoses on “overprescribing,” leading advocacy groups to warn that restricting access to pain medicine puts pain sufferers at risk of being undertreated.
CNN reported that in June, the Surgeon General said in a speech at the Aspen Institute, “I’ll tell you that just a few months ago, I was in Florida for an event and I met up with an old friend who’s a cardiologist. He’s trained at some of the best institutions in the country, he’s one of the most compassionate doctors that you’ll meet. And I was having dinner with him and I said, “Can you believe that we were taught that these opioid medications weren’t addictive in our training?” And he put down his fork and he looked up at me and he said, “Wait, you mean they are addictive?” like he didn’t know.”
Perhaps, Dr. Murthy was exaggerating to truncate a point, as it seems highly doubtful that any physician in the United States does not know that opioids can be addictive and abused. And, maybe, as the narrative surrounding prescription pain medicine begins to shift to counterfeit fentanyl and heroin use increasing as opioid prescriptions decrease, the government chose to find the front page of the papers in a different way – a first of its kind way.
Here is the letter. You tell us what you think about it.
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 two 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 at www.TurnTheTideRx.org. 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 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.
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.
(Signed: Vivek Murthy)