In an August 8 visit to St. Barnabas Medical Center in Livingston, New Jersey, to participate in a panel discussion, U.S. Surgeon General Vivek Murthy emphasized the important role that physicians must play in fighting the opioid crisis that is having a devastating impact across the country. As reported on August 9 by the Asbury Park Press, Murthy, who assumed the office of Surgeon General in 2014, had no idea when he entered medicine that substance abuse would become a defining issue in his career. “When I became a doctor, I assumed I would spend most of my days seeing people with infections, with diabetes, with heart disease and complications from cancer. … What I never imagined was that the majority of my time would be spent thinking about substance use disorders.” During the discussion, Murthy also observed that 40% of addicts suffer from mental health problems, and noted the failure of government to effectively address the correlation.

Over the course of his remarks, Murthy promoted Turn the Tide Rx, his office’s new initiative to encourage health care providers to become a part of the solution to the opioid crisis. The initiative’s website contains information and advice for providers related to proper prescribing of opioids for acute pain therapy, long-term therapy considerations and proper dosages. Among other things, it recommends that “clinicians should prescribe the lowest effective dose of immediate-release opioids for the shortest therapeutic duration. Three days or less will often be sufficient; more than seven days will rarely be needed.” The site also contains an opioid overdose toolkit and information about free training and Continuing Medical Education programs for physicians.

Joining Murthy on the panel were David Shulkin, the Undersecretary for Health at the U.S. Department of Veterans Affairs (VA), and New Jersey Senators Cory Booker and Robert Menendez. As reported by the Asbury Park Press, Shulkin noted that 60% of veterans returning from conflicts and 50% of older veterans suffer from chronic pain. Despite these high numbers, overall opiate use by veterans dropped 22% after a major initiative was launched in 2013. The initiative enabled the VA to reduce opioid dosages by 32% and the chronic use of opioids by 30%. For his part, Booker claimed that in order to increase the number of beds available to veterans seeking help, he is working to eliminate the cap on Medicaid funding that limits the number of treatment beds to 16 beds per facility