Public Health Forum Keynote: Opioid Abuse Is a Public Health Issue

Combining raw statistics with the faces of real people who have died from drug overdoses, and at the same time reflecting on his personal experience with substance abuse, Michael Botticelli took a decidedly human approach in his address at the 2015 MMS Public Health Forum, The Opioid Epidemic: Policy and Public Health. 

Botticelli, Director of the Office of National Drug Control Policy and former Director of Substance Abuse Services for the Massachusetts Department of Public Health, provided the keynote speech at the forum, which featured a range of experts discussing the medical, clinical, and legal aspects of opioid abuse.

Botticelli was clear and direct with two main messages for the 300 in attendance: “Opioid abuse should be regarded as a public health issue” and “we cannot afford to wait as a society to act” in responding to it.

He said five areas must be the focus of efforts by physicians, policymakers, legislators, and law enforcement officials to curb the abuse of drugs: education, prescription monitoring programs, storage and disposal, enforcement, and treatment.

Education: Botticelli noted that physicians receive little training in medical schools on opiates and prescribing and recommended that medical schools begin to establish courses in these subjects and urge, if not require, students to take them.

Michael BotticelliPrescription monitoring: Regarding them as valuable tools for research and to prevent “doctor shopping” by patients, Botticelli said prescription monitoring programs in the states must continue to be modernized and given more funding.  Noting that 49 states now have prescription monitoring programs, with Missouri on the way to becoming the 50th, he urged a nationwide infrastructure for such programs, with interstate data sharing and interoperability among hospitals, clinics, and health centers.

Disposal: Acknowledging data from the Centers for Disease Control that most of those who abuse prescription drugs use drugs that are prescribed to someone else, Botticelli recognized the importance of proper storage and disposal, saying we need to get the drugs “out of the home when no longer needed.”

Enforcement: While prescription drugs constitute a major part of the abuse problem, Botticelli said priority must also be given to the illegal trafficking in heroin.

Treatment: “People can succeed with the right treatment,” he said, and we must make “every effort to reduce the stigma to help people get the care they need.  If we want better outcomes, we need to pay attention to substance abuse disorders.”

Botticelli concluded his remarks with a message for health care providers.  “The medical community must remain engaged,” he said.  “The problem can be cared for by those who can provide the highest levels of care.  We don’t have time to waste.”

The slides for Mr. Botticelli’s presentation are available at

— Richard Gulla

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