MARY LOUISE KELLY, HOST:
One hundred seventy-five - that is the number of Americans on average that die every day overdosing on opioids. It's a statistic that was highlighted today by members of the White House opioid commission as they presented their final recommendations to President Trump. Those recommendations concentrate on how the government can ensure better treatment for people now addicted to opioids and try to prevent new addictions. Joining me now is Dr. Bertha Madras. She is a member of that commission. She's here fresh from the White House. Dr. Madras, welcome.
BERTHA MADRAS: Thank you very much for having me. I'm delighted to be here.
KELLY: Thank you for stopping by. So this final report that you all handed over in the White House today, it's 100 pages plus - so a lot of information and recommendations packed in there. If you had to point to the top thing that you all concluded needs to change to tackle this epidemic, what would it be?
MADRAS: I think the most important thing would be to produce treatment on demand.
KELLY: Treatment on demand.
MADRAS: That's right. I think that's critical. The second issue is if we do rescue, we have to have warm handoffs after rescue.
KELLY: And what does that mean? Explain.
MADRAS: Meaning that somebody should be available to provide treatment or medications assistance to know that that individual should not be alone after that because they're at risk of dying. A report came out yesterday that showed that 10 percent of people who'd been rescued died within one year. That is unacceptably high.
KELLY: Another thing that I'm imagining your commission concluded is unacceptably high is the problem with overprescribing. It's a subject that we have covered a lot, just trying to stop this at the front end of the issue of doctors' offices, which continue to write too many prescriptions for too many opioids, getting people addicted in the first place. Did your panel land on any prescription - pardon the word - to remedy that?
MADRAS: Oh, yes. We landed on a number of strategies. The most important thing to remember is that supply reduction is a form of prevention.
KELLY: So getting fewer pharmaceuticals out there in the market to be prescribed.
MADRAS: Well, above all, training physicians, mandating their training, finding out if they're adhering to the training, going to the Prescription Drug Monitoring database and seeing if their patients are at high risk and screening their patients to see whether or not they have in fact progressed to an addiction. One of the things that I focused on in the report, which is not prominent but I think is critical, is that people who overdose are still getting prescriptions for opioids from their physician. Ninety percent of them are, and yet, there's no reporting mechanism from first responders or hospital emergency rooms to report back to the prescribing physician, your patients have overdosed. Do something.
KELLY: So looking at changing those procedures, there's also - of course, there's many aspects to the problem but also the one that you can change - the way things are prescribed. That does not impact the situation on the streets where people are buying and using street drugs - heroin, fentanyl, et cetera. What did the commission conclude on that front?
MADRAS: The commission concluded that there has to be a concerted effort in reducing the supply of heroin and fentanyl and fentanyl analogues, such as carfentanil, which is showing up in more and more overdose deaths. And there has to be a concerted law enforcement effort in - at attacking that problem because that problem is now going - it's - in some states, it is the No. 1 reason why people are dying. It's no longer prescription opioids.
KELLY: Dr. Bertha Madras laying out some of the prescriptions laid out in the White House opioid commission report, which was given to the White House today. She is one of six members of that commission. Thank you so much for speaking with us.
MADRAS: You're very welcome. Transcript provided by NPR, Copyright NPR.
