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Georgia Department of Public Health commissioner gives address on opioids

Albany Herald - 9/3/2018

Sept. 03--ALBANY -- Dr. Patrick O'Neal, commissioner of the Georgia Department of Public Health, brought to the Region K Hospital Coalition's meeting last week a message concerning the ongoing opioid crisis in Georgia and what the state needs to do moving forward to combat it.

It was one of the stops O'Neal is making at health care coalitions throughout the state to present his case.

O'Neal said at the meeting, held at the Albany Civic Center, that the governor's race in Georgia will bring about change -- including the replacement of the current commissioners of the state's agencies -- but that change may not necessarily be a bad thing.

"Change will have to happen. I do enjoy the opportunity for change," he said. "It is a chance to make something better. No matter how good we have done, we have a chance to do something better."

O'Neal said the change is relevant to the opioid crisis in that it has presented a problem in Georgia that much of the rest of the country is facing. There are things that have to change in order for the problem to be dealt with effectively.

Even so, he said, the drugs themselves are not even the biggest problem.

"Opioids are the tip of the iceberg," O'Neal said. "The (bigger) problem is addictive disease. Opioids is a part of it, but what about the rest? We need to think ahead of the game. We don't want to be stuck on the opioids because (when that is over) there will be other things we have to deal with."

Opioids are commonly prescribed to patients recovering from broken bones or certain medical procedures. The ideal situation would be for a patient to come off the medication once they recover. Over time, O'Neal said, it is not difficult for what starts off as a legitimate prescription to become an addiction.

From a preparedness standpoint, O'Neal made the case that opioids are significant by recalling at the coalition's meeting a situation in a Columbus shelter in which people were coming to the shelter without their medical records and showing signs of withdrawal that behavioral health and addictive disease representatives had to address.

"What are you going to do if that happens here?," he said. "You have experience with shelters, too. Two-hundred people a day die of (drug overdoses). That is 70,000 a year. That's why it is a crisis, but it is also a crisis in terms of preparedness."

The DPH commissioner said the opioid epidemic is not something that can be solved in one year or two years, but rather it is a dilemma that will last for some time. The solution, ultimately, is to reduce the number of people dying by stopping people from getting addicted to begin with.

"These need to be our primary goals," O'Neal said. "Addiction is personal. I had a nephew who overdosed. He was saved the last time, but he might not be next time. It impacts everybody."

O'Neal said drugs present a Homeland Security problem when products not seen before work their way into the country and many people begin dying unexpectedly.

"Terrorists are changing the composition of street drugs in ways that makes these drugs fatal," he said. "Law enforcement is trying to stop the supply."

A 200-page report was generated by health officials in Georgia, and O'Neal presented it to Gov. Nathan Deal's office last month. The report outlines what is being done and what is still left to be done going forward. Six working groups are involved in the process, and the report has since been sent back for further fine-tuning.

"This is an ongoing issue," O'Neal said. "It will be an evolutionary-type of thing. We don't want this to be a public health plan. We want a state plan."

He said the plan involves measures such as implementing evidence-based strategies to prevent addictive disease, looking closer at how addiction during pregnancy can impact the affected newborns later in life, dealing with data and surveillance not often used adequately, enforcing new legislation requiring physicians to look at the state's prescription drug monitoring system before writing prescriptions, and investing more in treatment and recovery efforts.

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