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The Journal Record: A cultural change: Viewing opioid addiction as a brain disease

The Journal Record: A cultural change: Viewing opioid addiction as a brain disease

Panelists on a roundtable discussion on the state’s opioid crisis were Julia Jernigan, Oklahoma Behavioral Health Association; attorney Michael Burrage; Attorney General Mike Hunter; Jessica Hawkins, Oklahoma Department of Mental Health and Substance Abuse Services; and Dr. Jason Beaman, Oklahoma State University Center for Health Sciences. The rountable, held Wednesday at KOSU’s studios on Film Row in Oklahoma City, was moderated by The Journal Record Associate Publisher and Editor Ted Streuli.
(Photo by Brent Fuchs)

OKLAHOMA CITY – The nation’s modern-day Black Death is opioid addiction, said Dr. Jason Beaman.

“Like the plague in the 14th century and the HIV/AIDS crisis in the 1980s, this is the epidemic of our generation,” said Beaman, Oklahoma State University Center for Health Sciences’ chairman of the Psychiatry and Behavioral Sciences Department.

But Oklahoma is in the midst of a culture change, from viewing addiction as a moral flaw to seeing it as a brain disease. That perspective shift is necessary to help prevent addiction and to garner support from legislators to appropriate more money for treatment, said Jessica Hawkins, prevention services senior director at the Oklahoma Department of Mental Health and Substance Abuse Services.

Attorney General Mike Hunter said he will address the drug problem in part by aggressively suing the pharmaceutical companies that mislead physicians into thinking opioid medications were safe for long-term use and not addictive. His lawsuit seeks compensation for the devastating effects those drugs have had on the lives of Oklahomans. But a regional effort is also necessary, he said.

Hunter, Beaman and Hawkins were among several speakers Wednesday on a panel about the state’s ongoing crisis and how state agencies, physicians, educators and nonprofits are addressing the problem. The Journal Record hosted the hourlong roundtable event at KOSU’s studios on Film Row in Oklahoma City.

Oklahoma ranks among the nation’s worst for non-medical use of prescription drugs. More people are turning to heroin as the state tightens controls on prescriptions and increases requirements for monitoring a patient’s medication history. Heroin overdoses have doubled in just a few short years.

Though medication-assisted detoxification treatment has increased, that’s not enough to solve the epidemic, Hawkins said. As many as 800 Oklahomans are turned away from drug treatment daily, because the Oklahoma Department of Mental Health and Substance Abuse Services doesn’t have enough money to handle the crisis.

View the roundtable video here

“It will be telling how we overcome this without the appropriate resources,” Hawkins said.

Julia Jernigan, executive director with the Oklahoma Behavioral Health Association, said it’s critical for the public to understand that opioid addiction is a brain illness. That’s critically important when agencies and nonprofits ask for more taxpayer dollars to address the issue.

“We would never ask anyone with diabetes to wait until they were in a coma to get treated,” Jernigan said.

Hunter said he’s interested not in the so-called sue-and-settle technique, but rather getting compensation for the direct costs to the state. Attorney Michael Burrage is a former federal judge and one of the lawyers Hunter contracted to sue pharmaceutical companies.

The direct financial effect on Oklahomans is staggering, Burrage said: more than $4.3 billion in 2005. That’s about $5.48 billion in 2017 dollars, adjusted for inflation.

“These were false representations made to doctors to prescribe opioids so pharmaceutical companies could line their pockets with billions of dollars,” Burrage said. “That’s billions, not millions.”

Oklahoma has a prescription monitoring program, which in 2015 became required for every doctor and for every pharmacist prescribing or dispensing a controlled substance to check a database. That program helps monitor and flag potential doctor- and pharmacy-shopping.

But Missouri doesn’t have a similar program. Hunter said he spoke with his counterpart Josh Hawley and will address Missouri’s legislature with Hawley when the next session begins.

Oklahoma and neighboring states must work together to streamline efforts to prevent excess opioid supply from moving across state lines, and to crack down on doctor- and pharmacy-shopping, Hunter said.

There are disparities between rural and urban areas. Hawkins said she sees that when she examines county-level data on the number of opioid prescriptions, as well as when she sees data on overdoses.

Beaman said some of the challenges doctors in rural areas face is that they can often be the only provider in town. They don’t have the luxury of referring a patient to a pain management or addiction specialist. It’s also a challenge for those physicians to close their clinic to attend continuing education courses necessary to understanding up-to-date prescribing practices and how to treat patients suffering from addiction.

Rural areas have been hit hardest, in West Virginia, in Appalachia and in Oklahoma, Beaman said.

“Historical trauma is one reason why people are seeking these substances,” he said.