Addressing the opioid crisis gripping the state and nation requires a multifaceted approach, beginning with understanding the core issue, the state's top doctor told University of Pittsburgh at Johnstown students on Wednesday.
"Addiction is a medical condition. It is not a moral failure," Dr. Rachel Levine, secretary of health, said during Pennsylvania Opioid Crisis and prevention forum in the John P. Murtha Center for Public Service and National Competitiveness.
Levine outlined the state's response to the crisis as part of a panel of experts assembled by juniors and seniors in the educational law class under Ray Wrabley, political science professor and chairman of social sciences and business enterprise divisions at Pitt Johnstown.
Other speakers included Ronna Yablonski, Cambria County Drug Coalition executive director, Amy Arcurio, Greater Johnstown School District superintendent, Amy Snyder, Glendale School District teacher and Botvin LifeSkills facilitator, Fred Oliveros, Cambria County Drug and Alcohol Program administrator and Jason Rilogio, recovery work group chairman for the drug task force.
The state's three-pillar approach to the opioid crisis is showing results, Levine said. The focus on prevention, rescue and treatment, has continued to reduce the number of overdose deaths since 2017, she said.
Levine gave a brief history of what she says led to the current situation, using her oft-repeated label as a "perfect storm."
It began when the medical community began an emphasis on treatment of acute and chronic pain, which evolved into an attempt to eradicate pain for all patients.
That was about the time the pharmaceutical industry rolled out stronger opioids said to be non-addictive to pain patients. They included Oxycontin. The claim was based on limited studies that turned out to be wrong, Levine said.
Finally, there was an influx of cheap, powerful heroin that patients turned to when the prescription drugs became difficult to obtain.
"You put those factors together and it exploded into the opioid crisis," she said.
Confronting the crisis begins with prevention, which includes re-educating doctors and pharmacists on opioid use. Levine said the state's Prescription Drug Monitoring Program has not only helped reduce "doctor shopping," it has helped law enforcement identify illicit providers.
The state's robust drug take-back program has also reduced access to other people's prescription drugs.
Rescue, the state's second pillar, centers on access to naloxone, also known as Narcan. The state has provided thousands with free Narcan to use as an emergency treatment for overdose.
"Our goal is that all first responders have been able to get free naloxone from the state," she said, adding that the argument naloxone enables addicts to continue abusing drugs is not valid.
"I reject completely that someone with the disease of addiction doesn't deserve to have their life saved," Levine said. "It's impossible to get into treatment or get into recovery if you are dead."
Reviving overdose victims with Narcan gives first-responders the chance to get them to the emergency room and referred for treatment, she said, noting that warm hand-off program is increasing the number of those individuals getting into treatment.
The warm hand-off program involves connecting overdose patients with services before they are discharged.
"This area has worked very, very hard at the warm hand-off," Levine said.
Although law enforcement continues to be an important part of the response, Levine stressed filling the prisons with those suffering from a medical condition "doesn't make sense."
Understanding the disease of addiction remains the most important first step.
"It's so important for us to provide hope," Levine said. "I think the key is hope."