NEWS | June 24, 2019

U.S. surgeon general calls for advocacy, partnering with communities


Jerome Adams is on a mission. As the “nation’s health cheerleader,” he encourages everyone – students, physicians, nurses, public health specialists and businesses – to get involved.

Jerome Adams holds naloxone, a medication that quickly restores normal breathing to a person who is overdosing with heroin or prescription opioid pain medicine. Jerome Adams holds naloxone, a medication that quickly restores normal breathing to a person who is overdosing with heroin or prescription opioid pain medicine.

“We often fail to connect with our community,” Adams said. “We get inside our walls and clinics. We see patients when they come to us. We don’t go to them.”

As an example, he highlighted the resurgence of measles, an infection that is preventable with a vaccine.

Since 2018, the number of measles cases have tripled in the U.S. The majority of Americans do get vaccinated. But clusters of unvaccinated people combined with travel to countries with large measles outbreaks have allowed the virus to spread.

Adams recognizes the challenges that primary care physicians have in reaching people who are misinformed about the safety of vaccines.

“Mom or dad may be skeptical about vaccines,” he said. “At a clinic visit, I have 30 seconds to convince parents that a vaccine won’t hurt them or their child even though they read otherwise on the internet. A national vaccine campaign won’t appeal to those who don’t get vaccinated. They are not on twitter. It is up to us to get to their community.”

Building stronger communities, a more prosperous nation

Adams believes individuals and businesses that advocate for health can have a tremendous impact and change the future. Improving individual health leads to stronger communities, more business opportunities, as well as the overall prosperity of the nation, he said.

He used the example of Amazon setting up headquarters in Crystal City, Va., an area surrounded by healthy communities.

“They are moving to communities where there is a workforce,” he said. “They want healthy, young and educated people. Healthy communities lead to a healthy bottom line.”

He also believes Amazon arguing for more healthy communities will have more of an impact, move people to change than the U.S. surgeon general and physicians alone.

Reducing the stigma of opioid misuse

Over 2.1 million people in the U.S. use opioids and every 11 minutes someone dies from an overdose. Improving these odds is about reducing stigma and providing medication-assisted treatment (MAT).

For Adams and many others, there is a personal connection to addiction. His brother had a history of untreated anxiety and depression. He became addicted after going to a party and taking a pill, which then led to heroin use and stealing. He is now in prison. Incarceration costs more than treating depression or funding opioid diversion and prevention programs, Adams said.

“Stigma is the biggest issue,” he said. “Stigma keeps people in the shadows not getting treatment. We need to normalize addiction as a disease. It’s not that addicts come from a ‘bad’ family. My family raised a surgeon general of U.S. and also raised my brother, who has an untreated substance use disorder.”

He also emphasized that treating pain doesn’t mean patients have to endure more pain. There are multimodal treatments and other options that can produce better pain control.

Treating opioid addiction

Knowing CPR, carrying naloxone and having syringe programs in communities can also help address addiction.

“We need you all to walk the talk and be prepared to respond to cases of withdrawal,” he said. “Every medical student who is graduating should know how to recognize and treat addiction. They should be prepared to prescribe MAT and carry naloxone. This needs to be standard of care like high blood pressure.”

Treating opioid use disorder offers the chance for a brief intervention and referral to treatment. Adams urged the audience to lean into prevention and decrease prescribing.

“The opioid epidemic is a tremendous tragedy but it’s also an opportunity,” he said. “We’ve been here before. If we use it to show how we can be better partners, we can achieve their goals and ours.”