Surgeon General Jerome Adams Discusses Opioids and the Importance of Partnerships at NASHPCONF17
US Surgeon General, Vice Admiral Jerome Adams, MD, whose motto is “better health through better partnerships,” spoke at NASHP’s 30th annual State Health Policy Conference. It was a familiar venue for Adams, who as Indiana state health commissioner has attended NASHP conferences in the past and is a former NASHP Academy member.
As a state health commissioner, he worked to address an HIV outbreak in his state, spurred by unsafe injection practices resulting from the opioid epidemic, and worked on Indiana’s state Medicaid expansion. “I would not be where I am if it weren’t for NASHP,” he said during his opening remarks, complimenting the organization’s ability to share best practices and innovations in state health policy nationwide.
Adams, who was in Week 6 of the job when he spoke at the conference in Portland, OR, on Oct. 24, is head of the nation’s Public Health Service and serves as the nation’s doctor and its voice for communication and cultural.
What are you doing to address the opioid crisis?
I was Indiana state health commissioner during the largest HIV outbreak in the United States, with 225 cases of HIV infection in Austin, IN. This was higher than anywhere in the world (225 of the community’s 3,700 residents were infected).
It was a resource-poor community and didn’t have the capacity or cultural readiness to accept some of the remedies. Folks hammer me because they want the science, my work will always be informed by the evidence, but science is just one variable when you talk about public health policy.
We need to invite new and different people to the table. At the end of the day, we had to bring in business, faith-based, and police communities to talk about the science. I want you to keep thinking about who is not at the table, and bring them into the fold.
The Department of Health and Human Services has put out a toolkit, and the Centers for Disease Control and Prevention is working to identify opioid hotspots in communities. For example, you will be law enforcement’s best friend if you can help them focus their law enforcement and interdiction efforts, they will help you set up diversion programs so they can turn people turn toward recovery, instead of putting them in jail.
What about responding to the current increase in hepatitis C?
I think we are at a tipping point with hepatitis C, there are more people with hepatitis C than all of the other CDC-reportable diseases combined. The opioid epidemic allows us to raise discussions about hepatitis C as never before. (Hepatitis C and B have begun to increase for the first time in decades because of unsafe injection practices that transmit these bloodborne diseases.)
I would challenge you to take this opportunity, so we can ride this wave and get this into public discussions. The opioid epidemic is tragic, but it gives us an opportunity to talk about mental health, HIV and hepatitis C. Have those discussions and bring other partners to the table.
What concrete steps can the people in this audience take to support these efforts?
It’s OK to have partisan camps from a political view, but don’t let that blind you from working with the other side. It hurts my heart to see the political dissent. Try to find common goals. Think of one person who is not at the table and reach out to them and invite them to your next meeting to start that discussion.
One person alone may not seem that they’ll make a big difference, but all of us together can.
How are you reconciling all of the opposition to issues that impact public health?
I am a public health advocate, and I know we need to change some basic things. We’re focused on jobs, safety and security, and they’re ranked equally high by Republicans and Democrats. I try to reframe the public health discussion in a way that doesn’t mean me telling people that they should think the way we do.
Instead of telling teachers you should care about obesity, instead offer exercise as a way to increase test scores and fight obesity. Yes, things can seem disappointing from a public health point of view, but there are opportunities to show people how prevention can help.
I was able to get a syringe exchange program instituted in one of the most conservative communities in the country by working with police and letting them know they can reduce arrests and jail over-crowding through this program, and working with businesses to see how this program would improve the community and its reputation.
Click here to read the Surgeon General’s comments that accompanied President Trump’s comments on the opioid epidemic delivered Oct. 26, 2017.
Pictured are Cheryl J. Roberts, Deputy Director of Programs, Virginia Department of Medical Assistance Services, and Surgeon General Jerome Adams.