The United States is in the middle of an opioid crisis. Dr. Andrew Kolodny, one of the nation’s leading experts on the prescription opioid and heroin crisis and co-director for the Opioid Policy Research Collaborative at the Heller School at Brandeis, has been doing his part to encourage efforts to stop the epidemic.
A senior scientist at the Institute for Behavioral Health at the Heller School at Brandeis, Dr. Andrew Kolodny has been part of the Brandeis community for five years. In 2013, he moved his grant to Brandeis because of the vast research being done here about the opioid crisis. He has become much more involved at Brandeis this past fall since taking the position of co-director for the Opioid Policy Research Collaborative.
Kolodny said that he chose to move his grant to Brandeis because “before the opioid issue was in the limelight, some of the best work was being done at the Heller School at Brandeis.” As he said in an article published by the Heller School, “The Heller team had access to an incredible database of narcotic prescriptions from multiple states, and the ability to do research with that data was very attractive… many other universities are still way behind in responding to the opioid epidemic, but at Heller you had an entire team of folks who were working on this issue for years.”
Kolodny is also the executive director of Physicians for Responsible Opioid Prescribing, a group dedicated to reducing morbidity and mortality caused by overprescribing opioid analgesics. However, he has been doing work with the opioid crisis for fifteen years, starting in the New York City Department of Health and Mental Hygiene in the Office of the Executive Deputy Commissioner. His first task out of medical school was to reduce drug overdose deaths in New York City. He helped to develop and implement programs such as city-wide buprenorphine programs, emergency room screening and referral to treatment programs for drug and alcohol misuse.
He initially noticed that most of the deaths due to heroin were in the poorest neighborhoods in New York, stemming from the 1970s heroin epidemic. In the 1970s, the epidemic mainly hit teenagers in low-income, primarily non-white communities. Continuing with his work, a new opioid crisis became clear, affecting those of many other backgrounds and ages outside of the mostly non-white, low-income communities. This new crisis was beginning with pills prescribed by doctors.
“Our main interest is efforts to bring the epidemic under control,” Kolodny stressed about the focus of his research. Overall, it is not completely clear what works well and what does not to fix the crisis; however, Kolodny and his team are trying to inform the policy makers about the research that has been effective in order to make changes.
Kolodny explains how this new crisis is evidently caused by the medical community over-prescribing such highly addictive medications. The opioid prescriptions have been increasing since the 1990s. Kolodny stated that “over the past twenty years, there has been a 900 percent increase.” He also stressed that it is important to understand why doctors are prescribing these dangerous drugs so often.
Pharmaceutical companies, such as Purdue Pharma (which produces Oxycontin), have been pushing doctors to be more lenient when prescribing painkillers. Kolodny says that the way that pharmaceutical companies have made such a change in prescribing habits is by “marketing designed as education.” Doctors, including himself, are drilled to believe that these opioids do more help than harm to people and that people only get addicted in rare cases.
Kolodny defined the epidemic as “a very large increase in the number of Americans addicted to opioids over a short period of time.” This past year there is evidence to show that fewer Americans have become addicted to opioids than previous years; however, there is still a long way to go before reasonable levels are reached. In order for the epidemic to subside, “the incidence number of new cases must decline,” Kolodny said. The two strategies that he proposes are preventing addiction and treating those who are currently addicted.
In order to prevent addiction, it is crucial that doctors be more careful when prescribing opioids. Increasing access to treatments for people already addicted is also very important, according to Kolodny. A treatment that he talks about is using a drug called Buprenorphine. However, access to this drug is limited.
Looking into the future, Kolodny says that he and his team at the Heller School have more grant money coming to further their research about diminishing the opioid crisis. They are also seeking funding and philanthropy in order to have the flexibility to study what they think is most necessary. Kolodny’s overall stance is that the issue is not abuse but rather addiction. He insists that opioids are not a safe treatment for chronic pain because of the danger of addiction that has become so prevalent rather than people simply abusing the drugs. Over the past fifteen years, Kolodny has become an influential voice for opioid crisis research, despite his views that go against the pharmaceutical companies’ interests.
As Kolodny mentioned to BrandeisNOW reporters after his address to the National Governors Association Conference, “The opioid crisis should not be defined by the specific opioids involved in overdose deaths…This is an epidemic of opioid addiction…We need to prescribe opioids much more cautiously to prevent opioid addiction, and we need to improve access to effective outpatient addiction treatment for those suffering from this awful disease.”