A silent epidemic affects communities throughout the US

By Barbara Gutierrez

A silent epidemic affects communities throughout the US

By Barbara Gutierrez
A University panel of experts will look at the possible prevention and treatment of opioid use disorder.

The numbers reported by the Centers for Disease Control and Prevention (CDC) are staggering. There were 70,237 drug overdose deaths in the United States in 2017. Of those, 47,600 were from synthetic opioids. Declared a national public health emergency in 2018, opioid use disorder claims 130 lives a day.

“The opioid epidemic is one of the country’s most pressing challenges,” said Guillermo “Willy” Prado, dean of the University of Miami Graduate School, Leonard M. Miller Professor of Public Health Sciences, and director of the Division of Prevention Science and Community Health at the Miller School of Medicine.

Prado will moderate the panel  Tackling Opioid Addiction: Implications for Prevention and Treatment” at 5 p.m. on Monday, Feb. 24 at the Newman Alumni Center.

Sponsored by the School of Education and Human Development and its Department of Educational and Psychological Studies, the discussion will include Viviana Horigian, associate professor in the Department of Public Health Sciences; Ellen Vaughan, an associate professor from Indiana University and alumna of the University of Miami; Tyler Bartholomew, a Ph.D. student in the Department of Public Health Sciences; and Florida Rep. Michael Grieco, D-Miami Beach.

Dr. Hansel Tookes, assistant professor in the Department of Medicine at the Miller School of Medicine, will also attend. Laura Kohn-Wood, dean of the School of Education and Human Development, will offer remarks.

The discussion will center on ways to help the many opioid addicts in this country. Statistics show that a growing number of people started abusing the drugs, including OxyContin and fentanyl, after they were legally prescribed to reduce pain.

A prevailing problem in the treatment of these patients is the stigma that often surrounds their addiction, said Horigian, who directs the Florida Node Alliance of the National Clinical Trial Network at the University, and has led many studies about opioid addiction.

“There is a lack of awareness and denial,” said Horigian. “If we were talking about diabetes no one would question that you may need medication and diet. We as a society play a big role in destigmatizing the problem.”

The stigma extends to some health care providers who may believe none of their patients is addicted or that the addiction is a problem of the “poor and homeless,” said Horigian. But, according to national experts, the problem crosses all income levels.

Like many other ailments, “opioid use disorder is a treatable disease,” said Tookes, an infectious disease specialist, with extensive experience in treating patients with AIDS.

“We have three FDA approved medications to offer patients. The issue is how difficult it is to prescribe these medications—there are so many regulations and restrictions,” he said.

Horigian’s work centers on how to educate health care providers, nurses, and emergency room personnel on how to screen individuals with opioid use disorders, as well as provide strategies on how to obtain the waivers and permits necessary to prescribe the medications needed for their patients. With proper instruction, it should not be difficult to integrate these methods into physicians’ workflows, Horigian noted.

One model, now being used by UHealth, uses a nurse care manager to assist health care providers—in family and internal medicine—on how to get the waivers and paperwork and correctly fill them out for submission. This allows the doctors to be able to prescribe the correct medications, said Horigian.  

In the upcoming panel discussion, Vaughan will address Indiana University’s efforts to curb opioid use disorder in their state with a $50-million-grant project launched in 2017.

As an associate professor in the department of counseling and educational psychology, Vaughan’s focus is on educating and training future addiction counselors . Studies have shown that counseling, coupled with medications, is a very effective way to treat substance abuse.

Vaughan has developed a curriculum that includes ways to  identify some of the signs that may make a person vulnerable to addiction.

Among these are genetic and geographic factors: Does the person have other family members who a have a substance abuse disorder; or, is the person living in an area with heavy substance use?

Vaughan said all these factors have to be taken into consideration in order to counsel the patient adequately and prevent and treat opioid use disorder.