Less than a week after the state health commissioner declared opioid addiction a public health crisis, Lt. Gov. Ralph Northam met with Carilion Roanoke Memorial Hospital leaders Wednesday to discuss solutions to the state’s growing drug problem.
Northam, a pediatric neurologist, is the presumptive Democratic nominee for governor next year, but acted in his official state role when he met with about a dozen Roanoke health professionals including Carilion President and CEO Nancy Agee.
Last week, state health officials issued an order that allows pharmacies to freely distribute naloxone, which can revive people who overdose on heroin or other opioids, to patients who may need the drug.
Northam said Virginia’s health commissioner, Dr. Marissa Levine, issued the standing order because more patients who are addicted to prescription pain pills are turning to heroin — a cheaper alternative — to get their fix. But some of those heroin users are buying drugs cut with the dangerous synthetic drugs fentanyl or carfentanyl, which is causing more overdoses, Northam said.
“When individuals that think they’re getting heroin obtain heroin that’s laced with either fentanyl or carfentanyl, it is literally deadly,” he said.
Three Virginians die each day from accidental overdose. Yearly, the deaths outpace the number of people killed in vehicle crashes in the state.
Carilion’s vice president of medical affairs, Dr. John Burton, likened opiate addiction to the three points of a triangle. One tip is opiate utilization, another is heroin and the last, rehabilitation. Addicts live in the middle and rarely escape because treatment programs for opiate abuse have an 8 percent success rate, he said.
“The addiction is so profound, you can’t get out,” he said.
Burton challenged Northam to encourage legislators to invest in successful treatment programs and to ensure that law enforcement cracks down on heroin trafficking to prevent further abuse. Educating the public, especially teenagers, about the dangers of opioids also could curb the growing abuses, he said.
Other Carilion officials suggested connecting Virginia’s prescription monitoring program to those in neighboring states to prevent patients from doctor-shopping across state lines to obtain pain pills prescribed by multiple doctors. Several officials suggested retraining physicians to prescribe painkillers only for serious health problems, and recommended vigorously training medical students on the dangers of opioid addiction.
Tom Milam, co-interim chair of Carilion’s department of psychiatry, called state policymakers’ intensified interest in solving the opioid crisis a “milestone” for the community and substance abuse patients. Virginia is progressing in identifying, understanding and rectifying the opioid addiction problem, he said.
Many medical facilities in Southwest Virginia are expanding their telehealth services so doctors can see patients via technology similar to Skype or FaceTime, Milam said. Additional telehealth resources could allow doctors to prescribe Suboxone, a drug used to treat addiction, to patients in rural areas without them having to drive for hours to be seen in person.
“We’ve got to reach them in their communities,” Milam said.
At the end of the hour-long discussion, Northam acknowledged solving the opioid crisis comes down to funding for additional treatment options. While naloxone is now readily available at local pharmacies, the state does not cover the costs of the drug, which runs an average of $120 per prescribed amount.
Without more funding for treatment options, physicians prioritizing other pain management options and educating medical students on the dangers of overprescribing opiates is a start, Northam said.
Following the discussion at Carilion, Northam spoke at the Law Enforcement Opioid Summit at the Hotel Roanoke. Northam and Del. Sam Rasoul, D-Roanoke, also hosted a listening session with members of Our Revolution and the Roanoke City Democratic Committee. The event was closed to the press.