The Single Thing You Can Do Today to Prevent Teen Overdose Deaths Tomorrow
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Three years ago today, I lost a bright and promising young patient, Emily, to an opioid overdose. At just 15 years old, she was a vibrant, bubbly, purple bang-streaked brunette with dreams of becoming a singer on Broadway. Her mother called me on a rainy Friday morning. Her voice trembled through the tears. She simply whispered, “We lost Emily.” My mind jumped to the last time I saw Emily, passionately belting out Andrew Lloyd Weber’s song Memory from the musical Cats in my office:
Touch me, it’s so easy to leave me
All alone with the memory, of my days in the sun
If you touch me, you’ll understand what happiness is.
Look, a new day has begun.
Despite her struggles with opioid use disorder, I believed in Emily’s potential for recovery. However, in the state of Virginia it is illegal for clinicians to prescribe the life-saving medication, buprenorphine (Suboxone) to those under the age of 16. Unable to access this vital medication in our home state, Emily continued to struggle with powerful opioid cravings while we tried less effective medications. It finally became too much for her.
Emily was not the only one in trouble. Opioid use disorder is devastating our youth. Spiked with additional substances like Xylazine, synthetic opioids like Fentanyl and Carfentanyl are more deadly and more available now than ever before. The current regulations in Virginia surrounding buprenorphine prescribing impede access to critical addiction treatment for adolescents like Emily who desperately need it.
Buprenorphine is one of the best weapons we have to protect Americans struggling with opioid use disorder. You can read more about Buprenorphine’s crucial role and underutilization in the addiction ecosystem in a recent article from The Atlantic entitled Why Has America Ignored Its Best Addiction Treatment? One addiction doc in the article sums it up best, saying, “The natural history of opioid use disorder is: People die.” So why would we restrict our most effective medication from those who have the most life to lose?
I knew that Emily needed buprenorphine before she died. But I also knew that it was illegal to prescribe it to her in my state. Forced to choose between saving a young patient and saving your medical license is a terrible place to exist.
On the anniversary of Emily’s death, I started thinking about how needless it all was. It made me sad and mad all over again. I should have been able to prescribe her the one thing that would have saved her life. Anger is a powerful motivator. So I submitted a formal request to the Virginia Board of Medicine to get rid of the regulation. If not me, then who? After all, there are many more Emilys out there.
As a result of the petition request, this month the Virginia Department of Health in concert with the Virginia Board of Medicine is now formally considering whether to update the state’s antiquated regulations and allow clinicians to prescribe buprenorphine to patients under 16, as well as to remove additional documentation requirements for doses higher than 24 mg daily. After reviewing all public comments submitted this month, the Board is expected to reach a final decision in early July.
This is where you come in. The public comment period is open now through July 2nd. This is where you can voice your support for these needed rule changes. You don’t need to live in Virginia to weigh in. The Board of Medicine will read each remark carefully. They will rely heavily on your feedback submitted this month to make their final decision.
Your input will determine the fate of these regulations. Your support will shape the outcomes of teens everywhere struggling with severe addiction. Your comments could ultimately save many young Emilys.
Fight against the temptation towards complacency. I get it. It’s easy to think, “Oh, others will weigh in. Others have weighed in. No need for me to do so also.” Not true here. In this instance, every. single. comment. matters. Each remark tilts the scale just an inch closer towards saving more lives. Towards creating more Broadway singers. Every comment will be read and carefully considered by the key decision makers. Please consider taking just a moment to visit the Virginia Department of Health's comment page here to express your support for these necessary changes. You can comment anonymously, or with your own name.
The opioid crisis has claimed far too many young lives, including Emily's. No doctor should be faced with the potential consequence of losing their medical license for prescribing the most effective medication to treat an otherwise deadly disease.
Virginia is considered a “bell weather state” that other states usually follow. This decision will influence addiction prescribing regulations all over the country. By advocating for more accessible treatment options, we can help ensure that other families (and providers) do not experience the same gut-wrenching loss that Emily’s family did.
Let’s work together to create a future, a new day, where every teen is given the chance to recover from addiction and thrive. Your input today can help make that future a reality tomorrow. Look, a new day has begun.
-Lauren