Dr. Leana Wen stands with, Michael Botticelli, Director of the White House Office of National Drug Control Policy, who moderated a panel about the costs of the opioid epidemic during the Clinton Global Initiative (CGI) America meeting.

On Tuesday, Dr. Wen joined President Bill Clinton, President Jimmy Carter, CEOs, government officials, philanthropists, Nobel laureates, NGO executives, and community leaders for a panel discussion at the sixth annual Clinton Global Initiative (CGI) America meeting. During the panel titled “Communities in Crisis: The Cost of the Opioid Epidemic,” Dr. Wen spoke with Director of the White House Office of National Drug Control Policy, Michael Botticelli, Director of the National Institute on Drug Abuse, Dr. Nora Volkow, and other experts to discuss the national opioid epidemic and shared Baltimore’s innovative approach to combatting the public health crisis.

“In Baltimore, more people die from overdose than from homicide,” Dr. Wen said. Following her appointment in January 2015, Dr. Wen declared opioid overdose a public health emergency and has implemented one of the country’s most aggressive platforms to prevent overdose, expand access to treatment, and improve education to patients and providers. “Preventing overdose deaths are one of our top public health priorities,” Dr. Wen added. “This is one of the ways we can save hundreds of lives every year.”

Following her appointment in January 2015, Dr. Wen has declared opioid overdose a public health emergency and was tasked by Mayor Stephanie Rawlings-Blake to lead the work of the Mayor’s Heroin Treatment and Prevention Task Force. Since issuing ten bold and progressive recommendations, BCHD is working with partners across the city to implement a citywide plan to prevent overdose, improve access to treatment, and improve education to patients and providers. During Tuesday’s panel discussion, Dr. Wen shared Baltimore City’s “3-Pillars” of Combating Opioid Addiction:

1. Preventing deaths from overdose:

In one of the most aggressive opioid overdose prevention campaigns across the country, Dr. Wen has expanded access to the antidote, naloxone, by:

• Leading a citywide effort to expand the use of naloxone, training more than 11,000 residents since October 2015, including in public markets, in drug court, and with police officers.
• Issuing a “Standing Order,” enabling Dr. Wen to prescribe naloxone for all of Baltimore City’s 620,000 residents; and
• Introducing a first of its kind online naloxone training to further reduce barriers to this lifesaving medication.

2.  Increase access to on-demand treatment and long-term recovery support:

Understanding that stopping overdose is only the first step in addressing addiction, Dr. Wen has expanded access to on-demand treatment, including:

• Launching a 24/7 phone hotline that connects residents with services and treatment information. Introduced less than six months ago, the line now fields 1,000 calls weekly;
• Raising $3.6 million in funding to build a community-based Stabilization Center that will offer a more effective way to address public intoxication;
• Expanding and promoting evidence-based treatments with medication-assisted treatment, psychosocial services, and wrap-around services;
• Implementing proven diversion programs, such as Law Enforcement Assisted Diversion Program (LEAD) which connects eligible users to a facility for treatment and social supports—rather than to central booking for arrest; and
• Adopting universal screening of patients in hospitals to make intervention available as early as possible for those with or at-risk for substance use disorders.

3.  Provide education to reduce stigma and prevent addiction.

In coordination with partners, the Baltimore City Health Department is educating the public and providers on the nature of substance addiction: that it is a disease, recovery is possible, and we all must play a role in preventing addiction and saving lives, including:

• Launching a public education campaign, “DontDie.org,” to educate citizens about the signs of overdose and how to save a life with naloxone;
• Targeted outreach to prescribers to implement citywide best practices for opioid prescribing. There were 259 million prescriptions written for opioids in 2014—enough for one prescription for every adult American. In response, Dr. Wen has sent “best practice” letters to every doctor in Baltimore City, encouraging more judicious opioid prescribing behaviors and co-prescribing of naloxone with opioids; and
• Alerting communities to emerging trends, such as the dangers of co-prescribing opioids and benzodiazepines, a combination that causes 33 percent of unintentional prescription opioid overdose deaths. Last month, Dr. Wen co-led a coalition of over 40 city health commissioners and state health directors, urging the FDA to require a ‘black box warning’ any time these two medications are prescribed together.

“Although Baltimore City has made significant strides, communities across the country need further support from the federal government to expand funding for on-demand, evidence-based addiction treatment for this disease that continues to afflict millions of Americans,” added Dr. Wen. “Addiction does not discriminate. There is much we can do as local jurisdictions, but we must continue to work in partnership to address this public health crisis.”