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Winter 2018 Opioid Epidemic

The Winter 2018 QCGH featured four panelists who presented their research, insights and experiences on various health issues as they pertain to the dynamics of the opioid epidemic, an issue that is currently plaguing public health and needs optimal focus.

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On February 7th, 2018, this winter quarter saw yet another successful Quarterly Conversations in Global Health (QCGH), and in fact had the largest turn-out of any of our past 3 years of Quarterly Conversations events! Held by the UC San Diego (UCSD) Global Health Program and Students for Global Health in conjunction with the Global Forum (International House), this quarter’s event made space for discussions regarding the prevalent Opioid Epidemic and its tremendous effects on community health.

Quarterly Conversations provides a forum for the Global Health community to come together to discuss relevant issues in the field from an interdisciplinary perspective and increase community interaction at UC San Diego.

We would like to give our special appreciation to our event co-sponsors: The UCSD Global Health Institute, and Associated Students for offering their continual support of QCGH.

We would also like to give a special thank you to the UCSD Study Abroad Office, UCSD Academic Internship Program, the National Council on Alcoholism and Drug Dependence, and the Drug Enforcement Administration (DEA) of San Diego for their active attendance and support through resources for our participants.

The Winter 2018 QCGH featured four panelists who presented their research, insights and experiences on various health issues as they pertain to the dynamics of the opioid epidemic, an issue that is currently plaguing public health and needs optimal focus.

Panel Recap

We were delighted to have Dr. Ivan Evans, Provost of Eleanor Roosevelt College, moderating the event as our Master of Ceremonies.

Dr. Loretta Stenzel first held the floor as the panel portion began. She is the Director of Adult Medical Services at the Federally Qualified Health Center Vista Community Clinic. Also a member of the San Diego County Medical Society Prescription Drug Abuse Task Force, Dr. Stenzel has had expertise in treatment of opioid dependency from a family medicine perspective. She analyzed the situation regarding the development of the epidemic through time and how it has blown up to become a contemporary problem that was not so pressing in the past. Dr. Stenzel then explained the neurophysiology of addiction, particularly its relation to dopamine as a survival mechanism, which is important to framing addiction as a disease that needs appropriate care, or conclusively: “Addiction is mostly about going from a pursuit of pleasure to a desire to escape misery.”

Dr. Stenzel highlighted one of the major causes of the epidemic as opioid overprescription from doctors, who are in an adversarial position both from the patients needing pain relief and their ethical prescribing responsibilities. An initiative called Medication Assisted Treatment (MAT) was brought into the conversation as a possible successful resolution to this problem. MAT, by intense training of physicians and methadome clinics, offers an alternative combination of drugs that can control overdosing and wean off dangerous drug addiction. The program proved its effectiveness by decreasing opioid-related deaths by 50%, while reducing criminal activity, illegal drug use and contribute to HIV/Hepatitis C control. Finally, Dr. Stenzel called for more attention and further resolutions to address the ongoing opioid problems.

Dr. Tribuzio is practicing Physiatry and Pain Management at Sharp Rees-Stealy, is the co-chair of the Universal Controlled Substance Precautions Committee & is also a committee member of the San Diego County Medical Society Prescription Drug Abuse Task force, working on the safe prescribing of opioids. She first reflected on the history of the opioid epidemic, originating from the gradually increasing pain medications prescribing habits after a faulty pharmaceutical-sponsored paper came out showing that it is safe to do so. As of now, we still have escalating mortality rates despite corrected knowledge. She emphasized the importance of taking a multifaceted approach to fighting the epidemic: combining safe prescribing, advancing the current non-medication treatment for pain relief, and limiting access to opioids. 

Finally, Dr. Tribuzio drew on her experience with the Sharp Rees-Stealy multidisciplinary committee, whose mission is to focus on increasing education and prescribing practices and advocating for access to naloxone or other treatment. The committee succeeded in decreasing the amount of opioid types prescribed by 25% over the past year, as well as worked to unify the ways various medical groups and medical staffs practice prescription, establishing community standards and other guidelines.

Dr. Mackey holds various positions as an Associate Professor of Anesthesiology and Global Public Health, and as an investigator at the San Diego Center for Patient Safety at UCSD School of Medicine. Dr. Mackey presented his innovative research on Opioid Infoveillance as an adapting method for modern-age data about drug overdose. The need for this research comes from the gradual obsolescence of traditional surveys due to lessened interactions with them and lack of meta data behind the surveys themselves. Infoveillance methods utilize practical and relevant social media data and extract them for opioid data collection, seeing as social media usage is now one of the dominant methods of communication amongst susceptible drug users. The research team develops algorithms to look at content and meta data from platforms like Twitter, Vine, and Instagram in order to collect information about differing types of usage and drug promotion. They further investigate online pharmacies and drug dealing sites as the market for controlled substances. This research provides high quality and direct data that is useful for the future collection of reasons for the epidemic, as well as the need to adapt through the sophistication of drug markets. Dr. Mackey also presented team-based competition programs aimed at developing appropriate and effective resolution on the drug crisis, which his team strategized on such ideas of working through different approaches and platforms, while also looking at the transition of drug uses.

Mr. Silverman is the CEO of Confidential Recovery and a 2008 CNN Hero of the Week Award recipient, nationally known for leading successful recovery programs and having over 31 years of continuous recovery himself. Mr. Silverman offered a different, more personal perspective from the other speakers. He shared his personal experience as a former drug user, including his blackouts, lost time, dealing with law enforcement, negative effects on his life, job and relationships, all before he decided to make a change and begin his sobriety. Mr. Silverman brought attention to the low rate of help-seeking amongst drug users and the many impacts of addiction on one’s life. He stated his hope to develop resolution amongst communities, families and physicians to fight the opioid problems and promoted recovery. Mr. Silverman ended the panel with an inspiring call for new generations to tackle the problem with their knowledge and lessons.

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