Q&A with CDC’s Debra Houry, M.D., M.P.H.

Debra Houry, M.D., M.P.H.What are CDC’s top priorities to reduce opioid overdose?

CDC’s role in this fight is unique—rather than treating individual patients, our job is to move data into action to prevent opioid overdose. To accomplish that, we have three main priorities:

  • Tracking national trends and improving data on opioid overdose. Timely information on prescribing and on health effects of opioids is critical to understanding the patterns and drivers of the opioid epidemic.
  • Working with states to scale up prevention efforts that work. States have access to major policy and program strategies that can help to prevent opioid overuse, misuse, abuse and overdose. For example, states run prescription drug monitoring programs (PDMPs), regulate controlled substances, license healthcare providers and run large public insurance programs such as Medicaid and workers compensation programs.
  • Equipping healthcare providers with data, tools and guidance for evidence-based decision-making. We know providers play a central role in ensuring safer and more effective pain management.

What do you foresee as barriers to addressing the opioid epidemic?

Medication-assisted treatment (MAT) and naloxone (which can reverse opioid overdose) are effective ways to respond to the opioid epidemic, but limited access to these treatments presents significant challenges. MAT, which combines medication with counseling and behavioral therapies, can decrease the frequency and quantity of opioids used and reduce the risk of overdose and death. Unfortunately, only an estimated 1 million of the 2.5 million Americans who might benefit from MAT are receiving it. Expanding access and capacity to increase coverage is essential. Businesses have a unique and critical role to play to address this epidemic; by providing adequate and appropriate services, they can positively affect the lives of employees, their families and their communities.

What CDC recommended policies and procedures can organizations like Kroger implement to prevent and address opioid addiction?

We are grateful for the many organizations and businesses across the United States that have already taken action to help protect their workforce from the misuse and abuse of prescription opioids. For those that want to do more, there are a few key areas to focus on. 

First, business can review healthcare benefits packages for options for pain treatment and programs for opioid use disorder treatment. Examples include:

  • Cover non-pharmacologic therapies like exercise therapy and cognitive behavioral therapy.
  • Make it easier to prescribe non-opioid pain medications.
  • Reimburse patient counseling, care coordination and checking prescription drug monitoring programs (PDMP).
  • Promote more judicious use of high dosages of opioids using drug utilization review and prior authorization.
  • Remove barriers to evidence-based treatment of opioid use disorder (e.g., eliminate lifetime limits on buprenorphine).

Second, businesses can offer education to employees about injury and pain issues and encourage them to take action, such as making informed decisions with their doctors, identifying signs of opioid use disorder and considering non-opioid therapies for pain management.   

How can businesses partner with CDC to provide educational material and resources to employees to discuss prevention and treatment options?

We are committed to getting our data and resources into the hands of those who can use it to take action and reverse this epidemic. To date, we have created a wide range of user-friendly materials that are for more traditional public health partners, like public health departments and healthcare providers. Our products include clinical tools, fact sheets, brochures, posters, graphics and training resources, and all are available for download. Going forward, we must find new ways of reaching people at risk. We value our partnership with businesses like yours, who can provide constructive feedback on existing materials and request materials that might equip businesses to better reach out to employees and their families and communities.

How do clinicians take advantage of CDC resources in their daily activities for associates and customers?

CDC has developed a number of clinical tools and resources related to safer opioid prescribing. These include a checklist for prescribing opioids for chronic pain, a tapering pocket guide, fact sheets, videos, and a mobile app. Released in December 2016, the app is designed to help providers apply the recommendations of CDC’s Guideline for Prescribing Opioids for Chronic Pain by putting the entire guideline, tools, and resources in the palm of their hand. Lastly, there are on-demand online webinars that include continuing education credits for healthcare providers.