Face to face with the developing opioid crisis

“These are numbers that we have never seen before.” Those sad words were spoken by Nora Volkow, MD, director of the National Institute on Drug Abuse, a division of the National Institutes of Health. On November 17, the National Center for Health Statistics reported that in the first full year of the pandemic, from April 2020 to April 2021, a record 100 thousand Americans died from drug overdoses. That is almost 30 percent more than in the previous year.

Most of these people were young – under 35 – and about two-thirds of deaths were due to opioid abuse. Opioid use disorder tears families apart, fills prisons, leads to dire health consequences, and causes enormous economic costs for all. A 2017 survey by the Centers for Disease Control and Prevention (CDC) estimated the cost of opioid use disorder and opioid overdose deaths to be more than $ 1 trillion that year.

Opioid abuse isn’t new. Street drugs like heroin and over-prescribed pain relievers have threatened healthcare for decades. But it has exploded in recent years and is now affecting an estimated 2 million Americans, largely due to the proliferation of powerful synthetic opioids like fentanyl.

The most effective treatment after Eric Weintraub, MD, Professor of Psychiatry at the University of Maryland School of Medicine (UMSOM) and Medical Director of Emergency Psychiatric Services at the University of Maryland Medical Center, is drug-assisted treatment. The Substance Abuse and Mental Health Authority says drug treatment greatly reduces the chances of death, improves retention of treatment programs, helps patients find and keep a job, for example, and improves birth outcomes in pregnant women.

Weintraub joined the University of Maryland, President of Baltimore Bruce E. Jarrell, MD, FACS, in the November 18 issue of Virtually face-to-face with President Bruce Jarrell to discuss the opioid crisis and a novel approach he and his colleagues are using to expand treatment in rural areas.

“The distribution has changed completely in the last 30 years,” explains Weintraub. “It used to be on the street corner, there is a drug dealer and you could trace the drug back to Colombia. Well, you know, things are sent in small packages over the internet and the mail because these drugs are so powerful, and then they are mixed with other drugs and sent to these rural areas. “

“So what was it that made you want to start in some of these areas that you have gone into? Why did you start there? ”Asked Jarrell.

“For many years, opiate addiction was primarily an urban issue. In Baltimore, we’ve had a problem since the 19th, late 60s, early 70s. Baltimore is known as the country’s heroin capital. It’s a port city, a lot of drugs would get through, ”said Weintraub.

In 2015, a colleague in Hagerstown, western Maryland, set up a treatment program. The center offered drug treatment and the colleague asked Weintraub for help. Driving to and from Hagerstown and Baltimore seemed untenable, so Weintraub and coworker Christopher Welsh considered adapting the School of Medicine’s existing telemedicine program to connect with patients.

“We found that this type of telemedicine treatment in an already established treatment program in the delivery of telemedicine was not much different than being face-to-face. They had a consultation, we could do their drug tests. We checked some graphs and found that our patients were doing just as well as those we saw in person. And that was in autumn 2015, ”said Weintraub.

Weintraub and his team have now broken new ground in telemedicine – actually many streets, mostly country roads. For the past two years, they have partnered with the Caroline County Health Department on the East Coast to provide mobile telemedicine. Your 36-foot purple and white telemedicine van uses encrypted video circuitry to connect patients and providers. The van is also manned by a nurse, drug advisor, and a peer recovery specialist.

A study of their results, recently published in the Journal of the American Medical Association, looked at their 94 patients – all of whom were treated within 10 miles of their home between June and October last year. The treatment was found to be as effective as traditional on-site drug treatment. Almost 64 percent remained on treatment after two months and 58 percent after three months.

The virtual audience watched many questions including the use of cannabis or CBD to reduce the use of opioid pain relievers in medical treatment, the growing adoption of telemedicine, the government’s role in reducing the influx of dangerous synthetic opioids, and more.

Check out the full program by accessing the link at the top of this page.

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