Heroes Of The Opioid Crisis: “We need to stop treating the two facets of this crisis as if they were mutually exclusive”, With Thomas Bognanno and Marco Derhy
…we need to demand that policymakers stop trying to treat the two main facets of this crisis — shutting off the supply of opioids and significantly increasing addiction treatment — as if they were mutually exclusive. They are not. They are inextricably entwined, and together they need to be addressed by policies that recognize they are parts of the same problem while representing a different population segment with diverse needs. This is one war and requires a coordinated strategy that deals with the people currently addicted to opioids who need to have unfettered access to treatment options, and concurrently, works to prevent another generation of people from going down the same dark hole of access to and misuse of opioids.
As part of my series Heroes Of The Opioid Crisis, I had the pleasure of interviewing Thomas Bognanno, president and C.E.O. of Community Health Charities, a nonprofit health expert with more than 30 years of experience. Prior to joining Community Health Charities in 2006, Tom had a distinguished 20-year career with the American Diabetes Association and the American Cancer Society. Tom serves on the ZERO: The End to Prostate Cancer Board of Directors, Zeta Beta Tau Fraternity Foundation, Board of Directors and Corporate Governance Committee for the Institute for Sustainable Development, and the National Health Council Membership Committee.
M.D; Thank you so much for doing this with us! Can you tell us a bit of your backstory?
I have spent my entire professional life in the nonprofit arena, focused on chronic disease, health and wellness.
Everyone reading this knows something about the opioid crisis rapidly overtaking our nation and bringing unprecedented devastation and pain. The numbers alone might be the first stumbling block someone has to overcome if they want to even begin to understand the depth and scope of this still-developing storm. They are so staggering, so hard to comprehend, that they tend to distract us from the root causes of this epidemic and delay further unified action by public and private concerns to stem the tide of death and destruction. Drug overdoses are the leading cause of death for Americans under 50, and deaths are rising faster than ever, primarily because of opioids. According to a recent New York Times article, overdoses killed more people last year than guns or car accidents and are doing so at a pace faster than the H.I.V. epidemic at its peak. In 2015, roughly 2 percent of deaths — one in 50 — in the United States were drug-related — and it is climbing.
As the C.E.O. of an organization that for over 60 years has partnered with almost all the nation’s premier health and wellness nonprofits, I feel that we have an obligation to do anything within our power to raise awareness, leading to increased understanding, of the root causes and social determinants that are feeding this ever-increasing downward spiral of addiction and descent into darkness unimaginable for most of us. Nonprofit organizations do not have the means to solve the problem on their own, but they can be a powerful ally in working with government and business to help the two million of our fellow citizens who have already succumbed to the enticements of opioids and to help prevent countless millions more from taking this one-way journey to hell.
M.D; Is there a particular story or incident that inspired you to get involved in your work with opioid addiction?
There are two stories that come immediately to mind. The first was a few years back when my wife and I attended a rally in Washington, DC, with hundreds of organizations from across the country gathering there to say that they were “fed up” with the lack of action from Congress on dealing with the opioid crisis. We didn’t attend because we were affiliated with any of these groups, but because the rally organizers had asked those in the D.C. area with trained service and emotional support animals to attend and to bring their pet with them to comfort the many there who had lost a loved one to addiction. We brought our affectionate Golden Retriever, Emma, and were soon overwhelmed with the individual stories of those there that day who were still grieving over their loss. Story after story, through tears and anger, we encountered people from all walks of life, from all segments of our society. Rich, poor, white, black and brown, business professionals and migrant workers. We saw a microcosm of our society in that first rally, the very fabric of our nation in full display, all bonded together with one tragic common thread — opioid and related addictions. That profoundly impacted me as I began to see this crisis not as an aggregation of facts and figures but as individual mothers, fathers, siblings and spouses, each pouring the story of how their loved one was introduced to pain killers and other compounds that act like opioids. Their pain, outrage, and still burning hope broke my heart and instilled in me a deep desire to do something about this problem.
The other story is more personal even than that. It is the memory of my younger brother, who, in the prime of life, lost all of his future and hopes and dreams as he died due to the ravages of an addiction that took control of his life since leaving his military service. Unable to cope with his pain and confusion, my little brother, only a year separated from me, left behind children, a spouse, and the rest of us who wondered why he could not fight that last battle, why his life ended as a tragic waste. His bright smile and impish ways haunt my memories to this day. I was not able to help. I didn’t understand addiction, and like most, felt that blame had to reside solely with the addicted. It was their fault, their lack of strength and resolve. I couldn’t have been more wrong, and that introduction to the stories of those individuals on the mall that day in D.C. began to bring some healing — and conviction to help others and raise awareness about why some yield to addiction regardless of their upbringing, their social status, their educational level, or the color of their skin.
M.D; Can you explain what brought us to this place? Where did this epidemic come from?
The opioid epidemic has been gaining strength for years and began to be recognized as a major problem as far back as 1991. That is when deaths began to rise alarmingly and paralleled an increase in prescribing opioids and related compounds for the treatment of pain. There are many players involved, and it is not my purpose to point fingers because, to some extent, all are guilty for letting this get out of hand. However, there is no question that this increase in prescriptions was fueled by inaccurate claims by pharmaceutical companies that the addiction risk was low. Along with this, we saw an increase also in the promotion of opioids for addressing pain issues in patients even though there was, at the time, very little data related to the long-term risk versus benefits. Opioids were readily available, and medical professionals prescribed them liberally.
Things escalated around 10 years ago, and the death count climbed, mostly from heroin abuse. As awareness grew about the dangers of over-prescribing opioids, people began to turn to other ways to feed the addiction. Heroin was cheaper, more widely available, and more potent. The unholy link between the skyrocketing rise in heroin deaths was that over 80% of heroin users misused prescription opioids before turning to heroin.
This unfortunate turn led yet again to another surge in opioid-related abuse and deaths five years ago when the synthetic drug fentanyl entered our everyday consciousness. The use of fentanyl introduced yet another complication to this tragic tale with the added weight of crime organizations that reap incredible profits by mixing heroin with fentanyl, which almost guarantees a death sentence for buyers who were often unaware of the power behind the pills.
M.D; Can you share three things that the community and society can do to help you address the root of this problem? Can you give some examples?
First, we need to get serious about putting into place comprehensive policies that will help to stem this deadly tide. Reducing the amount of access to prescription painkillers is a step in the right direction, but in and of itself, it is not enough. Funding efforts to stop the flow of illegal drugs into this county is a necessary step, but, again, by itself, it will not have the desired impact of eliminating the efforts by creative and well-financed drug cartels. Congress has allocated some money to address the crisis, over $1 billion, but it will take ten times that amount and then some to fund all the steps above and others if we truly want to achieve success in this war.
Secondly, we need to demand that policymakers stop trying to treat the two main facets of this crisis — shutting off the supply of opioids and significantly increasing addiction treatment — as if they were mutually exclusive. They are not. They are inextricably entwined, and together they need to be addressed by policies that recognize they are parts of the same problem while representing a different population segment with diverse needs. This is one war and requires a coordinated strategy that deals with the people currently addicted to opioids who need unfettered access to treatment options and concurrently works to prevent another generation of people from going down the same dark hole of access and misuse of opioids.
The third action we can all take and must take goes back to where I started this article — by confronting our own biases and lack of understanding. Our lack of empathy even. The mothers and fathers, sons and daughters, on the National Mall with me that afternoon did not blame the deaths of their loved ones on moral failures. I do not, and this has been a long and painful journey for me, blaming the death of my dearest little brother on his lack of moral conviction and strength. As a nation of compassionate and yet informed citizens, we need to understand that addiction truly is a chronic disease. A reoccurring disease at that.
No one willfully chooses a path that leads to total destruction, including loss of jobs, families, freedom, and ultimately their lives. At some level and critical point, the addiction slips beyond the individual’s control. Let’s address addiction as a national mandate. This crisis can be fought and won with the combination of effective and comprehensive legislation, enhanced access to treatment, and by treating the condition as a chronic disease of the body and the mind.
M.D; How can our readers follow you on social media?
@tbognanno1 on Twitter https://twitter.com/tbognanno1
Plus, our organization @healthcharities will engage.