NOV 05, 2020 7:30 AM PST

Keynote Presentation: The Opioid Crisis: Made in America...Fade in America

Presented at: Opioid Crisis 2020
C.E. Credits: P.A.C.E. CE Florida CE
Speaker
  • McLean Hospital and Harvard Medical School
    Biography

      Current position. Professor of Psychobiology, Harvard Medical School (34 years) with office based at McLean Hospital Belmont, MA and cross-appointment at the Massachusetts General Hospital. Educated at McGill University, Montreal; post-doctoral fellow MIT.



      Translational Research. Addictive and therapeutic drugs: behavioral, molecular responses. Drug discovery. Novel brain probes, candidate therapeutics for neuropsychiatric disorders



      Authorship.  Author of over 200 scientific manuscripts, articles, book chapters, co-editor of books “The Cell Biology of Addiction”, “Effects of Drug Abuse on the Human Nervous System”, “Imaging of the Human Brain in Health and Disease”. 



      Inventions.  19 U.S. and 27 international patents, with collaborators.



      Government service and public policy. Numerous NIH committees and other advisory boards




      • White House, 2006-2008: Deputy Director for Demand Reduction in the White House Office of National Drug Control Policy (ONDCP), Executive Office of the President, a presidential appointment confirmed unanimously (99-0) by U.S. Senate.

      • White House, 2017:  Appointed by the President, as one of six members of the President’s Commission on Combating Drug Addiction and the Opioid Crisis (Governors C. Christie, C. Baker, R. Cooper, Cong. P. Kennedy, AG P. Bondi). At request of Commission Chair Gov. Christie, she shepherded and wrote majority of the final Commission report.

      • World Health Organization: Sole author of a commissioned report, “Update of Cannabis and its Medical Use”; co-author of “The Health and Social Effects of Nonmedical Cannabis Use”.

      • U.S. Department of Justice: Sole expert witness for the U.S. Dept. of Justice in a landmark Federal Court decision on marijuana re-, or de-scheduling. DoJ position sustained.

      • Vatican Pontifical Academy of Sciences, Narcotics Panel: Co-author, edited final statement.

      • National Academy of Medicine: Current member, National Academy of Medicine Collaborative on the Opioid Crisis.



      Educator, Public Service. Over 300 presentations to students, public, professionals




      • Developed the first addictions course (elective) at Harvard Medical School; first NIDA-sponsored international course on Cell Biology of Addictions at Cold Spring Harbor Laboratory.

      • Museum exhibition: Project Director of NIDA-sponsored project, exhibit, CD, play at Museum of Science, Boston “Changing your Mind: Drugs in the Brain”. CD licensed to Disney Corp.



      Recognition




      • Research Awards: NIH MERIT award, CPDD Innovator Award, McLean Mendelson award, The Better World Report cited her brain imaging invention as “one of 25 technology transfer innovations (university to industry) that changed the world”. Public Service Awards: NIDA, CADCA, CPDD, Sweden, American Academy of Addiction Psychiatry Founders’ Award, others.



      Her experiences in research, brain biology, education, government and public service offer her a unique perspective on public policy, brain science and public education.


    Abstract

    The opioid crisis is a uniquely American challenge. Many factors catalyzed this national nightmare and others continue to fuel it. This presentation delves into some of the major contributors, offer suggestions for reducing this deadly public health problem, and describe challenges for implementation.   The United States stumbled into a series of imprudent decisions can be instructive: it is feasible to “reverse-engineer” past mistakes; it is  important to compile a  “lessons learned” list, a cautionary tale for future drug crises. The initial stimulus, overprescribing of pain-killers, is being gradually reversed, albeit now requiring thoughtful actions to prevent unintended consequences. Responses cannot remain stagnant and locked into fixed solutions, as emerging trends continue to challenge old premises. Illicit fentanyl and heroin now are the two leading contributors to overdose deaths, alone or combined with psychostimulant drugs such as cocaine and methamphetamine.  Prevention strategies based on reducing supply of fentanyl/heroin/cocaine/methamphetamine are clearly different from those involving prescription opioids. Universal principles of treatment, alternatives for pain management, evidence-based treatment involving medications, rescue, and long-term recovery support can be applied to those with an opioid use disorder regardless of chemical class of opioids. Nonetheless, challenges to implementation abound, from resistance to change, stigma, scalability and effective transitions of care.

    Learning Objectives:

    1. Understand why the opioid crisis is a uniquely American challenge

    2. Learn at least 4 factors (of  > 32 factors) that fueled the opioid crisis

    3. Lessons learned that can be applied to emerging drug threats

    4. Learn 12 principles of treatment and weaknesses in current system


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