The doctor says that while opioid prescribing is down, synthetic opioids are now driving the opioid epidemic.
The former CEO of the Cleveland Clinic said that the opioid epidemic has peaked now that more healthcare providers and laypeople are aware of the dangers of opioid painkillers.
“I think we’ve peaked,” Dr. Toby Cosgrove said on CNBC’s Squawk Box. “I think we’re starting to see the understanding of the problem, and getting to the point where people are certainly prescribing fewer drugs and people are recognizing how serious this is.”
However, he said that synthetic opioids are continuing to drive opioid deaths.
“The other issue is that drugs are now being laced with fentanyl and carfentanil, which are highly potent,” said Cosgrove, a cardiac surgeon who led the Cleveland Clinic hospital for 13 years before stepping down in 2017.
“Carfentanil is 10,000 times as potent as morphine. We just had an outbreak of deaths in Ohio from drugs being laced with very potent carfentanil and fentanyl,” Cosgrove noted.
Cosgrove now works as an executive advisor to Google Cloud Healthcare and Life Sciences team, and is a proponent for healthcare reform. During his CNBC appearance he talked about ways to reduce healthcare costs.
He noted that while the United States has the highest healthcare costs in the world, the country is about average in the amount spent on healthcare and social programs combined. He said that this shows that investing in social programs can help alleviate the burden of healthcare costs.
“Social programs, frankly, are driving down the healthcare costs” in other countries, he said.
Although there has been some leveling of opioid overdose rates in certain areas, the national overdose rate climbed in many places between 2016 and 2017. In fact, 45 states saw opioid overdoses increase 30% between July 2016 and September 2017, according to federal data.
During that time period, the Midwest—including the area served by the Cleveland Clinic—saw opioid overdose rates increase 70%, driven largely by an influx of synthetic opioids. In fact, fentanyl is a factor in nearly half of opioid-related deaths.
As Cosgrove suggested, opioid prescribing is down. However, this isn’t necessarily linked to a reduction in overdose deaths. In fact, West Virginia decreased the amount of opioids prescribed by 12% between 2016 and 2017, but still saw opioid-related overdose deaths rise. Because of this, some medical experts warn that the opioid crisis could continue to get worse before improving.
“I think we have to realize that we’re on a trajectory that may get a lot worse before it gets better,” said Donald S. Burke, dean of the University of Pittsburgh’s Graduate School of Public Health.