Will Murthy’s exit stymie opi­oid bat­tle?

Modern Healthcare - - NEWS - By Maria Castel­lucci

In a Face­book post writ­ten af­ter be­ing fired from his post as U.S. surgeon gen­eral, Dr. Vivek Murthy pointed to his work ad­dress­ing ad­dic­tion as a top ac­com­plish­ment.

“I am ex­ceed­ingly proud of what our team and our of­fi­cers have done to bring help and hope to peo­ple all across Amer­ica,” Murthy said when asked why he didn’t re­sign in­stead of be­ing fired by Pres­i­dent Don­ald Trump two years into a four-year post.

Af­ter be­ing ap­pointed by Pres­i­dent Barack Obama, Murthy high­lighted the opi­oid epi­demic as one of the Obama ad­min­is­tra­tion’s top pri­or­i­ties. He urged physi­cians to change how they pre­scribe pain med­i­ca­tion and worked to di­min­ish the stigma associated with ad­dic­tion. In a land­mark re­port in Novem­ber, he called ad­dic­tion one of the big­gest pub­lic health prob­lems of the past 50 years.

An HHS spokes­woman said Murthy was asked to re­sign af­ter “as­sist­ing in a smooth tran­si­tion” un­der Trump.

Rear Adm. Sylvia Trent-Adams, a 24year vet­eran of the U.S. Pub­lic Health Ser­vice Com­mis­sioned Corps and for­mer chief nurse of­fi­cer in the corps, will fill Murthy’s role on an in­terim ba­sis. Surgeon gen­eral is a con­firmed post and re­quires full Se­nate ap­proval.

The Trump ad­min­is­tra­tion’s de­ci­sion has some opi­oid ad­dic­tion ex­perts con­cerned that strides made to tackle the epi­demic will be stalled or squashed.

An­drew Kolodny, co-di­rec­tor of opi­oid pol­icy re­search at Bran­deis Uni­ver­sity, thinks the move is a step back­ward.

Kolodny said he ques­tions the Trump ad­min­is­tra­tion’s goals for com­bat­ing the cri­sis with Dr. Scott Got­tlieb’s nom­i­na­tion to lead the Food and Drug Ad- min­is­tra­tion, as well as the ru­mored pick to head the Of­fice of Na­tional Con­trol Drug Pol­icy, U.S. Rep. Tom Marino (R-Pa.). Both have strong phar­ma­ceu­ti­cal in­dus­try ties that some say could help col­lab­o­ra­tive ef­forts to curb prac­tices that aid ad­dic­tion. “I am wor­ried that we’ve just fi­nally started to see the real driver of the prob­lem—over­pre­scrib­ing,” Kolodny said. “If we lose the fo­cus on that, I’m wor­ried the epi­demic will never come to an end.”

Dr. Krisda Chaiy­achati, a physi­cian and re­searcher at the Uni­ver­sity of Penn­syl­va­nia who has stud­ied opi­oid use, be­lieves the Trump ad­min­is­tra­tion won’t give up on the is­sue. But, he added, “We haven’t re­ceived clar­ity on the strat­egy mov­ing for­ward” to com­bat the epi­demic.

There are also con­cerns over the pres­i­dent’s pro­posed 20% cuts to the Na­tional In­sti­tute of Health’s $30 bil­lion bud­get. A $500 mil­lion ap­pro­pri­a­tion to help states ex­pand opi­oid preven­tion ef­forts is not new fund­ing, but money pre­vi­ously au­tho­rized un­der the 21st Cen­tury Cures Act.

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