Walk down the hall on 2 East at Carilion Roanoke Memorial Hospital, and the magnitude of the opioid epidemic will hit you.
Roanoke Memorial is our region's Level 1 Trauma Center and the only tertiary/quaternary care center for 150 miles in any direction. We're used to seeing the sickest of the sick.
The patients on 2 East come from all walks of life. Many are there because they've developed an infection in their hearts due to drug use. These are serious, complicated cases and often result in six weeks of hospitalization. Many of the patients have been close to death, some have been close more than once. And, they may not be ready to address their addiction.
Life on 2 East can feel bleak. People try to sneak illicit drugs onto the floor to give to our patients. Patients are naturally scared of becoming "dopesick." Our doctors and nurses struggle to convey the gravity of the situation to their patients. The care emotionally taxes our staff. Hope can be fleeting.
Best-selling-author Beth Macy's latest book, "Dopesick," is an exploration of our nation's opioid epidemic that originated in our region of Virginia.
We all know the statistics — 72,000 people died of a drug overdose last year (more deaths than US soldiers lost during the entire Vietnam War), most of them due to opioids. It's dangerous to focus on the numbers alone, and Beth's book puts a fine point on the epidemic by introducing us to the patients and families whose lives have been devastated. For my neighbors and me, this epidemic is personal. Roanoke is the type of place where everyone knows everyone else. All of us have been touched by it.
I've known Beth for many years from her time as a reporter at The Roanoke Times. She's a good journalist, and she tells this story in a way that implores you to care. In the pages of "Dopesick," you'll meet mothers and their children, people like Kristi and Jesse, Janine and Bobby, Robin and Scott, Patricia and Tess. People I know…some are doctors or nurses. Your heart will break like mine has.
If nothing else, I want you to read this book because I want you to feel a renewed sense of urgency to do something. Our nation offers the most sophisticated healthcare in the world, and yet we're losing tens of thousands of able-bodied adults every year.
Now we must fight for our patients and avoid repeating the mistakes of the past.
Hospitals and health systems across the country are tackling the opioid epidemic. For our part, Carilion Clinic is doing a lot of work to address challenges from all angles.
Some initiatives are simple — we added drug take-back boxes at our pharmacies, and we hand out drug deactivation bags with certain prescriptions.
Some initiatives are more difficult — we monitor prescribers through a sophisticated dashboard that allows us to address those who might be prescribing above recommended levels. We're also resetting expectations about pain with our patients.
Some initiatives are short-term — we are encouraging journalists to change the language they use to reduce the stigma around addiction. For instance, we've encouraged them to stop referring to "drug-users" and instead call them "individuals with substance use disorders." After all, addiction is a disease state, not a moral failing.
Some initiatives are longer-term – we've begun work on a predictive analytics platform that could enable us to better identify when a patient is more prone to substance abuse.
And with all this and many other initiatives, we still see overdoses every day in our emergency department. The demand for our Medication Assisted Treatment program continues. And we rarely have an empty bed on 2 East.
That reality, and the raw emotions I felt reading "Dopesick," left me aching for hope.
I found it on 2 East. One of our newest employees — I'll call her Sarah — is a peer recovery specialist. She's had a difficult time, having struggled with addiction herself before finding her way into recovery. Ironically, her struggles are the most important prerequisite for her new job.
Every day, Sarah visits patients on 2 East. She shares her own story of addiction and recovery, answers questions about the treatment they're receiving and acts as a conduit for information between patient and provider. She is a shoulder to cry on, a sympathetic ear, and she doesn't shy away from offering tough love as well.
Sarah has been in her patients' shoes. She knows what they feel like. She knows their fears and their struggles. And most importantly, Sarah is a living, breathing example of what life could be like in recovery.
It's not unusual, Sarah tells me, for a patient to ask her how to become a peer recovery specialist. Sarah's patients want to be her one day. What is more hopeful and life-affirming than that?
The fight we are all waging against the opioid epidemic is accelerating. Pick up a copy of "Dopesick" and renew your commitment to the communities that depend on you. I know we have.