- Surgeon General: Doctors must help stop opioids


, @KenSerranoAPP4:19 p.m. EDT August 8, 2016

Drug and alcohol treatment in New Jersey has been declining. Advocates say that's because of a drop in indigent funding and other obstacles to access Wochit


U.S. Surgeon General Vivek Murthy has toured the country with the message that more money is needed to treat opioid addictions given a treatment gap that deprives about a million Americans of the help they need.

On Monday, Murthy stopped in New Jersey, this time focusing on the role clinicians can play to keep the epidemic at bay, from prescribing opioids for pain more cautiously to speaking out to legislators.

EXCLUSIVE: The Children of Heroin series

With him in a panel discussion at St. Barnabas Medical Center in Livingston were U.S. Sens. Cory Booker and Robert Menendez and Undersecretary for Health at the U.S. Department of Veterans Affairs David Shulkin.

Coming to Washington after taking on the job of surgeon general at the end of 2014, Murthy's goal was to apply what he saw as a practicing physician to the nation’s health care problems, and opioids were the biggest problem, he said.

“When I became a doctor I assumed I would spend most of my days seeing people with infections, with diabetes, with heart disease and complications from cancer,” he said. “What I never imagined was that the majority of my time would be spent thinking about substance use disorders.”

YOUR OPINION: Is it time to have drug addicts committed?

Murthy related a story from that tour about an Arizona man now recovering from an opioid addiction who told him about the power that addiction has to alter your judgment.

The man, who had been treated for testicular cancer, got bad news a while later that the cancer had returned.

“He was elated,” Murthy recalled the man telling him. “The reason he was so happy was because he figured he’d get another chance to get a prescription for opioids.”

Murthy was touting his office’s initiative called Turn the Tide RX, which guides clinicians on how to change their practice and connect more people to treatment. He also addressed the co-occurrence of mental health problems and addictions.

Some 40 percent of those with addictions also suffer from mental health problems, he said.

“Traditionally we haven’t done well on either front,” Murthy said. “Those services (for mental health) when they are available are often disconnected from traditional medical care.”

Prejudice and stigma for both illnesses keep many people from coming forward, he said.

MORE: Police: Woman shoots heroin into teen who ODs

Shulkin of the VA reported progress in the use of opiates among veterans.

Overall opiate use by veterans has dropped 22 percent after a major initiative was launched in 2013. The VA reduced opioid dosage by 32 percent and reduced chronic use of opioids by 30 percent, he said.

But that progress came after an explosion in prescriptions for veterans that lasted for more than a decade, leading to a fatal overdose rate that was nearly double the national average, according to the Center for Investigative Reporting.

In 2013 the center found that prescriptions for hydrocodone, oxycodone, methadone and morphine had surged by 270 percent in the prior 12 years.

In 2015, the center reported that the number of opiate prescriptions at the U.S. Department of Veterans Affairs medical center in Tomah, Wisconsin, quintupled from 2004 to 2012. Oxycodone pills dispensed there rose from 50,000 to 712,000 during that period, the center reported.

Shulkin said that 60 percent of veterans returning from conflicts suffer from chronic pain, as do 50 percent of older veterans, about double the percentage for the overall U.S. population.

New Jersey’s veterans are making even more progress than the country on the whole in terms of limiting their use of opioids, he said.

Nationally, 12 percent of veterans are on opioids. In New Jersey, it’s 5 percent, he said.

Shulkin attributed the VA’s recent success with its integrated system that uses, for instance, a single source for electronic medical records that clinicians working on a case can access.

Ken Serrano: 732-643-4029;