Two of Maryland’s top experts on public health and addiction medicine have published a book this week that seeks to demystify the opioid epidemic that has ravaged the state and nation with staggering overdose death tolls.
The authors — Dr. Yngvild Olsen and Dr. Joshua Sharfstein, who also happen to be married — co-wrote “The Opioid Epidemic: What everyone needs to know” to deliver the most basic facts about the drug, addiction, treatment and recovery before providing more information tailored to individuals, families, community leaders and lawmakers.
“The state of confusion on opioids is its own crisis,” said Sharfstein, Baltimore’s former health commissioner and Maryland’s former health secretary. “We’re starting to see that confusion lift in some places.”
Sharfstein, a vice dean and professor at the Johns Hopkins Bloomberg School of Public Health, said much of that confusion centers around how people talk about people suffering from “substance use disorder,” a phrase that the book says is less stigmatizing than addiction or substance abuse.
Olsen, a clinical physician and vice president of the American Society for Addiction Medicine, cited a study that showed how even public health professionals held more negative attitudes toward a patient described as a “substance abuser” than one described as having a “substance use disorder” even though their cases were the same.
Another prevailing stigma is that people expect a quick fix — including 28-day programs and the increasingly popular belief that medical cannabis can treat opioid addiction.
“There is no evidence that marijuana can cure this,” Sharfstein said. “There is great evidence out there for the treatments that exist. But they’re not quick fixes.”
Those include medications such as methadone, buprenorphine and naltrexone. Gov. Larry Hogan signed legislation that is a first for Maryland: requiring every county jail and Baltimore’s state-run detention facility to provide addiction screening, counseling and treatment those three federally approved medications.
“People can and do recover,” Olsen said. “They move away from the symptoms and behaviors that are out of control and cause harm.”
As the book title says, learning everything you need to know can help avoid the false concepts and missteps that many families, policy makers and even doctors can make. In 2018 in Maryland, 2,114 people died of opioid-related overdoses, up 5 percent from the year before. But progress was made as heroin and prescription opiate overdoses declined.
“We believe that the state of confusion is not a permanent state,” Sharfstein said. “That with good information people can do things that can help their families, and communities, cities, counties and states can take actions that can really save a lot of lives.”