March 27, 2024


JANUARY 11-13, 2024

Dear Members:

This is the third in a series of communications to provide a summary of the topics discussed at the American Medical Association (AMA) State Advocacy Summit (SAS), which I attended at the beginning of this year. The meeting was packed with enlightening information on a list of topics from a variety of panelists that I want to share with you.

Fentanyl, Stimulants, Hallucinogens

and Other Substances

(#3 in a Series)

The third in my series of communications from the AMA State Advocacy Conference is a discussion on "Fentanyl, Stimulants, Hallucinogens, and Other Substances."

There was a very good panel at the State Advocacy Summit on fentanyl, stimulants, hallucinogens, and other substances which have had a devastating impact on in our communities.

According to Traci Green, a leading expert in the field, the United States is grappling with a staggering 111,000 overdose deaths, a crisis that has been brewing for over a century. The disparities are alarming, with younger individuals bearing a disproportionate burden, and an increased prevalence of stimulant use contributing to a toll on life expectancy.

The unregulated and toxic drug supply, often laced with substances like xylazine, poses a severe threat to public health and safety. Regrettably, the number one risk factor for overdose is the stigma surrounding substance use disorders, which impedes access to life-saving resources and perpetuates harmful stereotypes.

A recent Kaiser Family Foundation survey highlights the pervasiveness of this crisis, with two-thirds of Americans reporting either personal or family experience with drug or alcohol addiction, three in ten individuals or family members associated with opioid addiction, and one in ten individuals or family members having experienced a drug overdose.

While the challenges are daunting, there are helpful and important options available, such as fentanyl test strips and over-the-counter naloxone, which save lives.

Gordon Smith, the Director of Opioid Response in Maine, offers invaluable insights and a five-point plan to address this public issue of our time:

  1. Acknowledging that almost everything done over the past 100 years has been wrong, and the War on Drugs has failed to treat substance use as a medical issue rather than a criminal one.
  2. Recognizing the complexity of the problem and the absence of a total solution.
  3. Emphasizing the critical importance of prevention, starting from before birth, by improving social and economic conditions, and deterring adolescents from initiating substance use as a means of escape.
  4. Identifying barriers and challenges, such as the difficulty in accessing treatment, stringent requirements for buprenorphine, and the need to lower barriers to treatment to make it easier than obtaining drugs.
  5. Acknowledging that there is much more that can be done to address this crisis.

In Maine, positive strides have been made, including a 16% reduction in mortality, the distribution of 430,000 naloxone doses, and the deployment of 50 outreach workers to support overdose survivors and those at risk. Initiatives like the 1,000 Lives Campaign and the Recover Out Loud program are also making a difference by promoting treatment over recurrent arrests and providing alternative support systems.

If you get a chance, be sure to take a look at Teri Smith’s TED talk. From her TED Talk, “after gaining her own sobriety, Teri developed a passion for bringing awareness to addiction and helping those in need. Over the course of her 13-year career in addiction treatment, Teri’s open, transparent approach to recovery has helped hundreds of people achieve sobriety and reclaim their lives. Her tenacity for fundraising to aid those in need has increased the understanding that recovery is possible and should be lived out loud, free of shame.”

As a community, we must come together to destigmatize substance use disorders, increase access to evidence-based treatment and harm reduction services, and prioritize prevention efforts. Only through a comprehensive and compassionate approach can we overcome this public health crisis and save lives.

Please stand with me in solidarity, united in our determination to create a safer and more supportive environment for those impacted by substance use disorders.

Before I close, I would like to remind you about the upcoming MSD Interim Meeting. We have a lot of issues to discuss and I sincerely hope to see you there! Here is the registration link:

Look for my next communication next month highlighting another topic from this Summit.

Robert J. Varipapa, MD