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Stefan Kertesz, M.D., addiction and internal medicine specialist at The University of Alabama at Birmingham
The President’s task force on the opioid crisis holds its second meeting today, led by New Jersey Governor Christie. New projections suggest that more than 60,000 Americans will die of drug overdose this year, outpacing prior crises of AIDS and gun deaths in years when they were at their worst. Many of those overdoses will be due to opioids which include heroin, illicit fentanyl and medications sold on the prescription market.
Christie is expected to propose a significant loosening of federal laws, including Hippa, which protecti patient privacy in cases of opioid overdose.
“I think the question of whether to inform families of overdose, absent consent, merits discussion because it is a near death event,” said Stefan Kertesz, M.D., an addiction and internal medicine specialist at the University of Alabama at Birmingham, “However, if those families have very little access to evidence-based treatment for their loved one, as is the case today, it is a futile gesture that will not save many lives at all.”
Kertesz says the primary challenge for the nation now is to assure adequate access to addiction treatment and the US has made almost no progress on this issue.
“Evidence based medications including buprenorphine offer a 60 percent reduction in mortality, making it one of the most powerful treatments available to medical care. But for most people with addiction, such treatments are not available because of both funding limitations and barriers to doctors taking on the work. Those barriers include regulations and lack of training. We can do better,” Kertesz said. “But it starts with leadership demanding that American medicine take addiction care on as part of regular care, and provision of mental health and addiction treatment. The reality is that requires money, insurance and coverage.”
Kertesz says another issue is that strict federal laws cordon off addiction treatment information from all other aspects of the medical record, and that prohibits health care providers from effectively managing the care of patients who have both addiction and medical problems.
“We need to allow for medical records to be integrated,” he said. “I am fully aware that addiction poses complex, ethical problems and for many people, moral questions. But in the end, good health care requires that caregivers know what is happening to their patients.”
Kertesz has commented nationally, pointing out that further prescription control will not stop the crisis because the crisis itself has changed.
“Prescription control is an ‘easy target’ that misses most of the problem,” Kertesz said.
Kertesz has defended his case in peer reviewed articles, including a scholarly article in the journal Substance Abuse published this winter, and has already become the second most downloaded article in the history of the journal. He has also made the case through a series of letters, lectures and commentaries appearing in venues from STATNews to TheHill.com, and his work has been featured on Vox.com.