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August 11, 2020 (Cleveland, OH)

Opioid Consortium Welcomes Admiral Brett Giroir to Virtual Meeting

Admiral-Brett-GiroirThe Northeast Ohio Hospital Opioid Consortium was joined virtually last week by Admiral Brett Giroir at its quarterly membership meeting. Adm. Giroir is assistant secretary for health at the U.S. Department of Health and Human Services (HHS). As the primary public health and science advisor to HHS Secretary Alex Azar, Adm. Giroir’s work includes coordinating HHS’ efforts across the administration to fight America’s substance use crisis as well as overseeing COVID-19 testing efforts.

In his remarks to Opioid Consortium members, Adm. Giroir shared recent data on substance use disorders, offering insight on what’s happening nationwide as well as factors that are unique to Ohio.

Based on national data from the Centers for Disease Control and Prevention, the headway that had been made in 2018 and early 2019 on the opioid crisis has reversed. Nearly 72,000 people died in 2019 of overdose nationwide, a 4.8% increase over 2018. In Ohio, the increase was even greater, at 6.9%. Synthetic opioids – mainly fentanyl and fentanyl analogues – were the most common cause of overdose. Adm. Giroir pointed out that a differentiator in Ohio is the presence of carfentanil, which is not as prevalent in other states.

Dr. David Streem, physician chair of the Opioid Consortium and chief of psychiatry and medical director of alcohol and drug recovery services at Cleveland Clinic, shared that prior opioid epidemics generally have been followed by stimulant epidemics, which was borne out by the data shared by Adm. Giroir. At the national level, cocaine as a cause of overdose had been trending downward. However, more recently that trend has reversed and overdose attributable to cocaine, along with psychostimulants, primarily methamphetamine, once again has been on the rise. 

Provisional Drug Overdose Deaths by Drug or Drug Class: Ohio


Impact of COVID-19
COVID-19 has exacerbated challenges for the 47.6 million Americans with a mental or behavioral health disorder and the 20.3 million individuals with a substance use disorder. An analysis of urine screen data from Millennium Health indicates illicit use of fentanyl, methamphetamine, and cocaine has increased when compared to pre-COVID timeframes. According to the Overdose Data Mapping Application Program (ODMAP), which issues alerts when there are spikes in the incidence of overdose, there were nearly double the number of spike alerts in April 2020 compared to April 2019.

While these statistics are grim, there are some glimmers of hope. Thanks in great part to the concerted efforts of those in healthcare, deaths attributable to prescription opioids have declined. And the federal government continues to prioritize this issue, for example through the HEALing Communities study and opioid response grants. Due to the rise in the use of methamphetamine, federal agencies are also increasing funding and attention to researching new treatments for related substance use disorders, which are lacking. 

At the same time, under COVID-19 the provision of services using telehealth has been unfettered, allowing opioid treatment programs to provide therapy and counseling with audio only, for example. Adm. Giroir reiterated what’s been heard from other federal officials, including Centers for Medicare and Medicaid Services Administrator Seema Verma, regarding an ongoing commitment to telehealth and an intention to maintain many of the expansions implemented under the public health emergency declaration.

The Center for Health Affairs is appreciative that, especially during such an incredibly busy moment for the nation’s public health system, the Admiral made the time to meet with the Opioid Consortium, share his insight, and assure the members, even in the shadow of COVID-19, of the continuing prioritization of the opioid and substance use disorder crisis facing the country.

For more on the work of the Northeast Ohio Hospital Opioid Consortium, contact us.

The Northeast Ohio Hospital Opioid Consortium welcomed Assistant Secretary for Health Admiral Brett Giroir, who joined members virtually to share insight on the opioid and substance use disorder crisis.