In a town hall session on the U.S. opioid epidemic on Thursday, National Drug Control Policy Director Michael Botticelli enlisted DOs’ help in using non-opioid pain management options whenever appropriate and in treating patients with substance abuse disorders. Osteopathic physicians, Botticelli said, are well-positioned to make a difference in both areas: “As DOs, you look at the whole health of the patient, and that’s critical because it helps with finding and addressing the underlying causes for issues.”
Botticelli, who’s also known as the U.S. “drug czar,” spoke to DOs ahead of the AOA’s House of Delegates meeting; his remarks were featured in a newscast (above) on TV station WGN 9 Chicago. Botticelli’s specific recommendations for physicians include:
- Get training to prescribe buprenorphine, a drug that reduces withdrawal cravings, blunts the pleasurable effects of opioids and is used in medication-assisted treatment for substance use disorders. Training is available through the Substance Abuse Mental Health Services Administration, as well as the American Osteopathic Academy of Addiction Medicine.
- For patients with pain, follow CDC guidelines to use opioids as a last resort and “start low and go slow” when opioids are needed. Use alternative treatments, including osteopathic manipulative treatment, whenever possible.
- Prescribe naloxone, which reverses the effects of opioid overdose, to patients in recovery. “I know it can raise patients’ eyebrows, but I think it’s prudent,” Dr. Botticelli explained.
Cleanne Cass, DO, has been involved in advocacy in Ohio aimed at stemming the opioid crisis. “We were able to close pill mills, expand the drug reporting database that watches for red flags like doctor shopping, and update the guidelines for chronic and acute pain management to include non-pharmaceutical modalities for treating pain,” she said. “All of us can make a huge difference in ensuring the osteopathic voice is heard.”
‘The other side of addiction’
Despite the challenges, Botticelli is optimistic that the stigma around substance use disorders is decreasing. “One of the bright spots is people who are talking proudly about their recovery,” Botticelli said, noting he’s in long-term recovery himself. “The recovery community is showing that you can have an incredibly vibrant, loving, productive life on the other side of addiction.”