During the Christmas and holiday season, we enjoy the opportunity to spend time with our family and loved ones. So it’s an appropriate time to remember how important it is to secure the blessing of a loving family for every American, and it’s appropriate that November marks National Adoption Month.
The Department of Health and Human Services plays an important role in helping American families adopt children now in foster care. HHS’s Children’s Bureau, part of the Administration for Children and Families, funds and partners with federal, state, tribal and local agencies to improve the overall health and well-being of our nation’s children and families.
America now has more than 430,000 children in foster care, from infants to 21-year-olds, and new data released by HHS this week found that there are now more children in foster care than ever. We are happy to note that in 2016, there were more adoptions out of foster care than ever.
However, we need to improve our adoption rate, the need is especially urgent for teenagers. Like the rest of us, teenagers need strong, loving, permanent families to help them get their bearings in the world, live healthy and productive lives, and contribute to their communities and their country. Sadly, youths between 15 and 18 are often overlooked in foster care adoptions.
Statistics show that about 20,000 of the youths currently in foster care will likely not find permanent homes before they leave the system (which occurs at between 18 and 21, depending on the state where they live). These teens, many of whom were abused, neglected or abandoned, will then be completely on their own. A range of evidence suggests that making this transition to adulthood without the guidance and support of parents can bring a host of challenges later in life.
That’s why the HHS Children’s Bureau has a new initiative to promote awareness of the need for teen adoption. In partnership with the Ad Council, AdoptUSKids, and the advertising agency KBS, the Children’s Bureau has a new series of ads called “What to Expect When You’re Expecting … A Teenager.”
The series highlights the importance of adopting teenage girls and boys from foster care and emphasizing that adoptive parents do not have to be perfect to be a perfect parent to a youth from foster care. We all know no parent is perfect; good families are created out of commitment and love.
The Children’s Bureau also partners with AdoptUSKids and Child Welfare Information Gateway to promote awareness of this issue during National Adoption Month each year. This year’s theme is “Teens Need Families, No Matter What,” which highlights the need to find permanent, safe families for this vulnerable group, as well as to emphasize the importance of making youth adoptions successful.
Helping children and youth find the loving, permanent families they need and deserve is a key part of our goals at HHS of building better health and stronger communities.
We each have a role to play in helping these children and teenagers—whether it’s choosing to be a foster or adoptive parent or supporting those who are. Go to AdoptUSKids.org or call 1-888-200-4005 (English) or 1-877-236-7831 (Spanish) to receive information about the foster care system and the adoption process.
Each day, according to the Centers for Disease Control and Prevention, more than 140 Americans die from drug overdoses, 91 specifically due to opioids.
These numbers are staggering and disturbing, but having a clearer picture of the devastating effects of the opioid epidemic across the nation can help us target interventions and develop new solutions to end it. To do this, we need data. Lots of data. We have to understand the epidemic in order to stop it.
We at the Office of the Chief Technology Officer (CTO) put out a call and more than 300 data scientists, programmers, coders and public health experts raised their hands to help us develop data-driven solutions to the opioid epidemic with the common goal of saving lives.
Over the last four months, our team has been working with our colleagues at HHS and data stewards from private industry and at the state and local level to compile data sets for the Code-a-Thon. On December 6 and 7, more than 50 coding teams will have 24 hours to work with these data and develop solutions to address one of three challenge questions:
How can we help federal, state, and local stakeholders improve access to effective treatment and recovery services?
How can we help federal, state, and local stakeholders identify at-risk populations and their underlying risk characteristics of opioid misuse or abuse?
How can we help federal, state, and local stakeholders predict and analyze the supply and movement of legal and illicit opioids?
In addition to data from HHS, we have data from other federal agencies, including the US. Department of Education, the U.S. Department of Commerce, the U.S. Department of Labor, the U.S. Department of Justice, and the U.S. Department of Transportation and data from state and local agencies including those in Virginia, Louisiana, Indiana, Washington, and North Carolina.
We have coding teams from across the country coming to Washington, D.C. for this event including teams from Nashville, TN; Austin, TX; Los Angeles, CA; Chapel Hill, NC and East Lansing, MI, to name a few.
The Symposium on December 6 will bring together leaders on the front lines of the opioid epidemic and influential leaders in health, data and technology to discuss how data and technology can be used to address the opioid epidemic. Many of the speakers at the symposium work with data and technology to address the opioid epidemic, which has proven successful in their communities.
Complex health crises like the opioid epidemic require a diverse group of stakeholders at the table and that is why we are bringing together state and local leaders, law enforcement, data stewards and policy leaders for two days with the common goal of developing innovative solutions to address the opioid epidemic and save lives.
An important value of the Office of the CTO is the notion that we alone do not have all the answers. We look for input from a variety of stakeholders to develop solutions to solve problems.
This epidemic has affected countless lives, families, communities and professions. This event is just one piece of the puzzle and will build on the important work taking place in communities across the country. The event also builds upon efforts already underway at HHS. In April 2017, the Department launched its comprehensive, evidence-based Opioid Strategy that provides the overarching framework to leverage the expertise and resources of HHS agencies in a strategic and coordinated manner. The HHS Opioid Strategy aims to:
Improve access to prevention, treatment, and recovery support services
Target the availability and distribution of overdose-reversing drugs
Strengthen public health data reporting and collection
Support cutting-edge research
Advance the practice of pain management
The Office of the Assistant Secretary for Planning Evaluation created a Data Brief for Code-a-thon participants to create an overview of the data sources that could be leveraged to study the opioid crisis within each of the five HHS strategic areas, highlight some of the key research questions within these areas, and summarize data linking strategies that can be used to support research on opioids.
If you are joining us on December 6 and 7 in Washington, DC, I want to personally say “Thank you.” Thank you for your work, thank you for your ideas and thank you for coming together with one common goal, saving lives.
During the holidays, many of us are tempted to go overboard—overeating, overspending, and overextending ourselves. But when it comes to our health, less may be better than more, especially during the busy holiday rush.
For instance, to avoid the weight gain that seems inevitable this time of year, try eating foods with less fat and added sugar. Less screen time for both children and adults may also help keep extra pounds at bay, especially if that time gets replaced with physical activity.
Although NIH research has shown the average holiday weight gain often isn’t as much as most people think—it’s less than a pound between Thanksgiving and New Year’s Day—even a pound a year can begin to add up over time, making it harder each year to lose the extra weight. And overweight and obesity—with which more than 70 percent of the U.S. adult population struggles—increase the chances of developing health problems such as diabetes, high blood pressure, and kidney disease.
No Holiday from Your Health
So how can you stay healthy this time of year? Don’t put your healthy habits on hold. Here are some tips to help you stay on track and lead you into a healthy new year.
Plan. Don’t go to a party hungry. Have a healthy snack before you leave—an apple, banana, or fat-free or nonfat yogurt—so you are less likely to overeat or make unhealthy food choices later on. If you’re concerned about not having healthy food options available, offer to bring a healthy dish to share.
Choose wisely. Go for the salads, cut-up vegetables and fruit, and lean protein, such as fish, chicken, or turkey breast without the skin. Try to avoid salad dressings, gravies, sour cream, and other toppings that can add extra sugar, salt, and fat. Select water, seltzer, or unsweetened tea when available. If you really want an alcoholic beverage, limit yourself to one. And if you want to enjoy the holiday treats, sample just one cookie or a small sliver of pie.
Focus on the festivities. Instead of lingering around the food table or bar, move around and meet someone new, catch up with friends or family, or participate in dancing or party games.
Sit less, move more. More than 2 hours of TV-watching a day has been linked to overweight and obesity. Turn off the TV, computer, and phone, and take a walk, play hide-and-seek, or toss a football around. If you’re shopping or running errands and time permits and it’s safe to do, park farther from where you’re going and walk the rest of the way.
Manage stress. Less stress is best, but when the holiday pressure is on, it can build and may lead to overeating. Physical activity can help relieve stress. Even if you’re pressed for time, squeezing three
10-minute walks into your busy day may make a difference.
Get enough sleep. Don’t sacrifice sleep to try to get more done. Some studies show that a lack of sleep may increase the risk of weight gain. Adults need 7 to 8 hours of sleep each night to maintain health.
Of course there will be temptations and setbacks, but don’t give up and don’t look back. If you overeat one day, get back on track the next—or as soon as you can. Recruit support from family and friends—they may share your goal of having a healthy holiday. With determination and support, you can achieve better health today, tomorrow, and for life.
The NIDDK website has tools and information to help you improve your health. You also can find healthy tips on our Facebook page and my weekly Healthy Moments radio broadcast. Learn more and listen to recorded episodes by searching “Healthy Moments” on the NIDDK home page.
Through innovative systems and unique partnerships, rural communities across the United States have made critical advancements toward improving their health outcomes. The Health Resources and Services Administration’s (HRSA) Office of Rural Health Policy and the National Organization of State Offices of Rural Health recognize National Rural Health Day on Thursday, November 16, by spotlighting the pioneering work of our rural communities.
This year’s National Rural Health Day focuses on the Power of Rural, how collaborations in rural communities and throughout HRSA support the delivery of quality healthcare in rural America.
National Rural Health Day is a time to recognize the countless strides rural communities have made. More than 800,000 rural Americans receive health services thanks to rural community-based grants. HRSA’s rural grantees have successfully leveraged funds to provide access to services across the healthcare spectrum. They have increased access to primary care, established early intervention services for patients with behavioral health needs, and expanded access to healthcare via telehealth. HRSA’s rural grantees have played a critical role in enhancing the quality and availability of healthcare services.
Dr. Sigounas visited Fairfax Medical Facilities in Newkirk, OK. From left: Claudia Dilbeck, Quality Coordinator, Fairfax Medical Facilities, of Newkirk, Okla.; Ryan Smykil (HHS/Indian Health Service); Dr. Sigounas; and Karen McConnell, CEO.
Along with acknowledging the accomplishments made by rural communities, it is also important to acknowledge the disproportionate obstacles that rural Americans must overcome. In the context of HHS priorities, rural Americans have poorer outcomes when it comes to substance abuse (particularly the opioid abuse epidemic), childhood obesity, and mental health.
While we have seen a rise in opioid abuse deaths on a national level, rural residents face an even greater disparity as rural states are more likely to have higher rates of overdose deaths, specifically from prescription opioid overdoses. Rural children face their own disparity when considering childhood obesity. Rural children aged 10 – 17 years have higher rates of obesity than their urban counterparts.
Additionally, while the prevalence of mental illness is comparable among urban and rural communities, the barriers lie within the availability and accessibility of mental health services.
But these challenges also present opportunities. This past September, HRSA awarded $200 million to health centers to address mental health and the opioid crisis. HRSA also awarded $3 million in grants to address the unique obstacles rural communities face in addressing the opioid crisis. This included three grants focusing on the use of telehealth to provide comprehensive substance abuse services.
Access to quality and comprehensive healthcare services is an essential focal point when thinking about the well-being of rural Americans. HRSA is working to foster access to quality healthcare through collaborative work and programs that include supporting rural health facilities, investing in Community Health Centers, and building a strong health workforce. HRSA supports nearly 1,400 health centers operating more than 10,400 service sites across the United States, with more than 40 percent of those health centers serving rural communities. HRSA is also working to increase access to healthcare providers through our health professional training programs. Through the Area Health Education Centers (AHEC) Program, a program to enhance education and training networks in order to improve healthcare delivery to rural or underserved areas, 41 percent of students and residents came from a rural setting. Additionally, 144 Rural Health Clinics partnered with AHECs to provide training experiences to students and residents. Also, in fiscal year 2017, roughly a third of National Health Service Corps and Nurse Corps members worked in rural communities, providing services in primary care, oral health, and mental health.
As part of National Rural Health Day, let us celebrate the successes of our rural communities and also take this time to reflect on how our partnerships, whether at the community, state, or federal level, can continue to transform and improve rural health outcomes. While rural communities face unique challenges, they also have unique ideas and solutions that bring the community together and engaged in ways to improve the lives of rural Americans.
Earlier this week, HRSA moderated a series of Twitter chats November 13-15. The topics were workforce development, the social determinants of health, and behavioral health, respectively. You can review the chats by following @HRSAgov or using hashtag, #OurRural.
During #NRHD, we recognize the considerable contributions that rural communities have made to improve health outcomes. https://go.usa.gov/xnZXp
Antibiotic resistance is a significant threat to our nation’s public health, and one that is spreading and evolving rapidly. It was only a couple of years ago that scientists discovered the emergence in China of mcr-1, a gene that makes bacterial infections resistant to colistin, an antibiotic that is increasingly used as a “last resort” treatment when others don’t work. Americans are already dying of untreatable infections.
This discovery and the robust multi-agency and international response illustrates the constantly evolving threat of bacteria that are resistant to antibiotics and the importance of widespread surveillance to detect new resistance types, quick response to prevent spread and development of new treatments.
As soon as the mcr-1 gene was discovered in China, the U.S. government began conducting surveillance for it here. Less than six months later, the gene was found in a patient in Pennsylvania. Given the mcr-1 gene’s ability to move to other bacteria and make them resistant, the federal government implemented an urgent public health response to contain and slow any potential spread, coordinating across multiple agencies and surveillance systems, and relying on collaboration and innovation. The CDC, FDA, USDA, DOD and state agencies all got involved to swiftly respond and prevent further spread of resistance.
The mcr-1 gene is just one example of the broad challenge of antibiotic resistance. Every year, more than 2 million people in the U.S. get infections that are resistant to one or more antibiotics, and at least 23,000 people die as a result. Another 15,000 or more deaths each year in the U.S. are caused by Clostridium difficile, a bacterium often associated with unnecessary antibiotic use and advanced age and can cause serious complications.
The increasing resistance to antibiotics puts at risk our ability to effectively treat sepsis or to provide effective care to cancer patients, organ transplant recipients, and burn victims, who are at higher risk of complications and infections. Drug-resistant infections can complicate the U.S. medical response to chemical, biological, radiological or nuclear emergencies. We’re also seeing more common infections, like urinary tract infections, becoming increasingly difficult to treat because of antibiotic resistance.
This is why the federal government developed the National Action Plan on Combating Antibiotic-Resistant Bacteria (CARB), to coordinate and enhance the public health response to the threat of antibiotic resistance in humans and animals, domestically and internationally. The Plan provides a five-year roadmap to guide the nation in reducing the prevalence of antibiotic-resistant bacteria by:
Slowing the emergence of resistant bacteria and preventing the spread of resistant infections.
Strengthening national surveillance efforts to combat resistance.
Advancing development and use of rapid and innovative diagnostic tests for identification of resistant bacteria.
Accelerating research and development for new antibiotics, other therapeutics, and preventive strategies, including vaccines.
Improving international collaboration and capacities for antibiotic-resistance prevention, surveillance, control and antibiotic research and development.
The federal government has been working diligently to implement the Plan since its release in 2015. As part of U.S. Antibiotic Awareness Week, November 13-19, 2017, HHS, on behalf of the Interagency CARB Task Force, has released a Progress Report to detail the significant progress made during the first two years of implementation of the National Action Plan. Highlights include:
The percentage of U.S. hospitals reporting antibiotic stewardship programs using CDC’s Core Elements for Stewardship rose to 64 percent in 2016, up from 46 percent in 2015. The goal is to reach 100 percent by 2020.
Methicillin-resistant Staphylococcus aureus (MRSA) in acute care hospitals declined by 13 percent between 2011 and 2014, and by a further 5 percent by 2016. C. difficile infections declined in acute care hospitals by 8 percent between 2011 and 2014, and by a further 7 percent by 2016.
CDC established the Antibiotic Resistance Laboratory Network, enhancing lab capacity to better detect, respond and contain resistance and resistant infections. CDC has invested in all 50 states, five large cities and Puerto Rico to detect and respond to CRE, “the nightmare bacteria.” CDC has also established seven regional labs to detect and support response to resistant organisms recovered from human samples.
Since the National Action Plan was released in March 2015, NIH has provided support to investigators through multiple funding opportunities and access to a wide array of preclinical resources designed to facilitate new drug development. These efforts are greatly expanding the pipeline of new drug candidates, at various stages of development, to treat antibiotic-resistant infections. In particular, the NIH-supported Antibacterial Resistance Leadership Group is pioneering an innovative clinical research agenda on antibacterial resistance.
As of April 2017, USDA’s Animal and Plant Health Inspection Service for the first time has begun conducting antibiotic use monitoring, resistance surveillance, and antimicrobial use surveys of beef feedlots and swine farms. These data are critical to understanding the relationships between antibiotic use and resistance in animals and humans.
In the past two years, FDA approved, cleared or granted marketing authorization for marketing several new diagnostic devices that may significantly enhance detection or prevention of antibiotic resistance.
Last year, NIH and the Biomedical Advanced Research and Development Authority (BARDA) launched the Antimicrobial Resistance Diagnostic Challenge, which seeks tests that identify antibiotic-resistant bacteria or that distinguish between viral and bacterial infections to reduce unnecessary use of antibiotics.
In July of 2016, BARDA launched CARB-X, a five-year, $450 million public-private partnership between BARDA, NIH, and the Wellcome Trust aimed at bolstering innovation in antibacterial product development. As of November 2017, CARB-X had granted awards to 23 biotech companies and research teams for drug discovery and development projects to tackle antibiotic resistance.
The U.S. Government has also worked with international partners, including the World Health Organization, the Food and Agriculture Organization, and the World Organization for Animal Health, to combat antimicrobial resistance. Through the Global Health Security Agenda, U.S. agencies have enhanced efforts to combat antibiotic resistance in over 30 countries.
This weekend, HHS wants to offer a special thank you to veterans of America’s armed forces. We are fortunate to currently have nearly 6,000 veterans serving the American people as part of our team here at HHS.
Many of them bring talents they put to use in uniform to their work here at HHS. One of them is Phillip Lynah, who served in the Army for 23 years, designing and building bridges, airfields and roads.
He worked on the Star Wars missile-defense initiative and eventually became the comptroller for military operations in Bosnia, responsible for the budget and spending in that theater.
Lynah eventually retired from the Army and joined the Department of Health and Human Services as the budget officer in the Office of the Secretary about nine years ago. He’s now chief of logistics management and policy at the Program Support Center, serving the whole department.
Everything he did in the military—budget, resource management, engineering—all fit into his future at HHS.
Lynah says he had to acclimate himself to a new culture of doing things at HHS. “It’s a transition, but you can do it. I enjoy it,” he said.
About 8.75 percent of HHS’s permanent, full-time employees are veterans. We are also fortunate to have about 6,500 public health professionals serving our nation in uniform today through the U.S. Public Health Service Commissioned Corps.
On Veterans Day — and every day — we honor and are grateful to Lynah and the thousands of veterans and Commissioned Corps personnel who join with the rest of us in providing the critical services that so many Americans depend on every day.
Thank you — and your families — for your service and sacrifice.
It’s officially flu season. Every year millions of Americans needlessly suffer from the flu, and thousands will be hospitalized or even die as a result of becoming infected with the virus. It’s heartbreaking that thousands of deaths from influenza still occur in our country every year. As a health care provider, your strong recommendation to your patients to get a flu vaccine this season can be a game-changer in reducing this disease burden.
I get my flu vaccine every year and hope you will too. Let your patients know you’ve gotten your flu shot and support vaccination for yourself, your family, and your community.
Here are five tips for communicating the importance of getting a flu vaccination this season:
Tailor reasons to the individual. Explain why someone — based on age, health status, lifestyle, occupation, or another risk factor — should get a flu shot. For example, the flu vaccine is especially important for patients age 65 or older because they are more likely to develop serious flu-related complications, such as pneumonia.
Discuss how vaccination prevents illness. From averting the flu entirely to reducing its severity if one does get sick, it’s important to remind patients of the many positive benefits of flu vaccination. The Centers for Disease Control and Prevention (CDC) outlines a number of these benefits of the flu vaccine on their website.
Outline the consequences of getting sick. The flu can result in serious health complications and time lost from work or family obligations. Prevention is better than treatment when it comes to any illness, and the flu is no exception.
Explain how vaccines protect loved ones. Influenza, like a number of other vaccine-preventable diseases, is contagious and can be serious. Vaccines do not just protect you; they also protect the people around you by limiting the spread of disease. Understanding how the flu vaccine protects their loved ones can be an important motivator for some patients to get vaccinated.
Answer and solicit questions with compassion. It’s normal to have questions about vaccines. Use easy-to-understand language to talk about patient concerns including side effects, safety, and vaccine effectiveness. CDC offers great resources to help you address common questions and educate patients. Vaccines.gov is a comprehensive website you can recommend to patients to help them learn about immunization.
You’re a trusted voice in the community. Patients trust you to give them the best advice on how to protect their health. Your counsel helps patients make informed decisions. As a standard of practice, all health care providers have the responsibility to routinely assess the vaccination status of their patients. Flu season provides yet another opportunity to make sure your patients are fully vaccinated.
Thank you for all that you do to keep Americans healthy. I hope you will continue to strongly recommend flu vaccines on social media using the hashtag #FightFlu. And, please follow @Surgeon_General and @HHSvaccines on Twitter for timely flu updates.
Over the past 15 years, communities across America have been devastated by increasing prescription and illicit opioid abuse, addiction, and overdose.
In 2016, 11 million Americans misused prescription opioids, nearly 1 million used heroin, and 2.1 million had an opioid use disorder due to prescription opioids or heroin. And every day, an estimated 90 Americans die from an opioid overdose—resulting in more than 300,000 deaths since 2000. Meanwhile, an estimated 25 million Americans experience pain every day. For many of these individuals, this pain interferes with their physical and mental health, work productivity, and ability to engage in social activities.
The opioid crisis has a variety of causes. In many communities, it has been driven by both socioeconomic challenges and lack of attention to behavioral health issues. Research has also shown that the significant rise in prescribing of opioid pain medications that began in the mid to late 1990s has been a key factor in the increase in opioid use, abuse, overdose, and death.
Transforming how we treat pain and recalibrating the role opioid medications play in pain care are a critical part of achieving the goals of reducing opioid harms and improving the quality of life for patients living with pain.
Rethinking pain treatment is a critical piece of the five-point Opioid Strategy HHS unveiled in April 2017. The strategy aims to:
Improve access to prevention, treatment, and recovery support services to prevent the health, social, and economic consequences associated with opioid addiction and to enable individuals to achieve long-term recovery;
Target the availability and distribution of overdose-reversing drugs to ensure the provision of these drugs to people likely to experience or respond to an overdose, with a particular focus on targeting high-risk populations;
Strengthen public health data reporting and collection to improve the timeliness and specificity of data and to inform a real-time public health response;
Support cutting-edge research that advances our understanding of pain and addiction, leads to the development of new treatments, and identifies effective public health interventions to reduce opioid-related health harms; and
Advance the practice of pain management to enable access to high-quality, evidence-based pain care that reduces the burden of pain for individuals, families, and society while also reducing the inappropriate use of opioids and opioid-related harms.
HHS is taking significant steps to implement the Opioid Strategy, including a long sought focus on advancing the practice of acute and chronic pain management. Our activities in this area fall into three categories: 1) Advancing national pain care policy; 2) Providing clinicians and patients with education and tools to improve pain care; and 3) Supporting cutting-edge research on pain.
Advancing National Pain Care Policy
National Pain Strategy Implementation
The National Pain Strategy outlines the federal government’s first coordinated plan to reduce the burden of chronic pain in the U.S. and provides a roadmap toward achieving a system of care in which all people receive high quality, evidence-based pain care.
The Strategy includes actions in six areas: 1) population research; 2) prevention and care; 3) disparities; 4) service delivery and payment; 5) professional education and training; and 6) public education and communication. As highlighted during a May 2017 public meeting, HHS and partner agencies and organizations are making significant progress in implementing the Strategy.
Pain Management Best Practice Inter-Agency Task Force
The creation of the Pain Management Best Practices Inter-Agency Task Force was announced by HHS in August 2017. The Task Force, mandated by the 2016 Comprehensive Addiction and Recovery Act, will include HHS, the Departments of Defense and Veterans Affairs, as well as the Office of National Drug Control Policy and various external pain stakeholders. The Pain Task Force will identify gaps or inconsistencies in pain management best practices, propose updates and recommendations to address identified gaps or inconsistencies and, as appropriate, submit updates to relevant federal agencies and the public.
Hospital Reimbursement and Patient Pain Management Experience
Health care providers have long expressed concern that scores related to pain management questions in the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey, tied to hospital reimbursement, could be leading to inappropriate prescribing of opioids.
In response to these concerns, starting October 1, 2017, the Centers for Medicare and Medicaid Services will no longer link the HCAHPS pain management scores to hospital payment under the Hospital Value-Based Purchasing program. This represents a significant step forward in aligning payment policy and clinical practice for opioid prescribing.
Providing Clinicians and Patients with Education and Tools to Improve Pain Care
Centers for Disease Control and Prevention Opioid Prescribing Guidelines and Tools
CDC’s Guideline for Prescribing Opioids for Chronic Pain was developed to help primary care doctors provide safer, more effective care for patients with chronic pain outside of active cancer, palliative, and end-of-life care. A number of Guideline resources have been developed for providers, including a series of interactive, online trainings and a mobile app that contains the Guideline recommendations, a morphine milligram equivalent calculator, and an interactive interviewing feature to help providers prescribe with confidence. CDC continues to engage with a broad range of stakeholders to support guideline implementation that meets the needs of patients and providers across many diverse care settings.
CDC Rx Awareness Campaign
In September 2017, CDC released its Rx Awareness communications campaign to increase awareness about the risks of prescription opioids and deter inappropriate use. The campaign features real-life accounts of individuals living in recovery and individuals who have lost someone to an overdose.
Food and Drug Administration Opioid Analgesic Risk Evaluation and Mitigation Strategy
FDA recently announced it is expanding its Extended-Release and Long-Acting Opioid Analgesic Risk Evaluation and Mitigation Strategy (REMS) to include immediate-release opioid analgesics.
Given that approximately 90 percent of all opioid analgesic prescriptions are for immediate release products, this change represents a significant step forward. As part of the REMS, FDA developed a new “draft blueprint” for prescriber education, expanding its content to include the principles of pain management, including non-opioid medications and non-medication treatments for pain; how to assess, treat, and monitor patients when opioids are appropriate; and information on the basics of addiction medicine.
National Institutes of Health Centers of Excellence in Pain Education
NIH funds Centers of Excellence in Pain Education at 11 academic institutions in the U.S. The Centers act as hubs for the development, evaluation and distribution of pain curriculum resources for medical, dental, nursing, pharmacy, and other health professional schools to improve how healthcare professionals are taught about pain and its treatment.
Supporting Cutting-Edge Research
NIH Public-Private Partnership
With the goal of bringing scientific solutions to the opioid crisis, NIH is exploring ways to promote safe, effective and non-addictive strategies to manage pain as part of a broader public-private partnership aimed at halving the time needed to develop new therapeutics to help end the opioid crisis. To advance the efforts, since June 2017, NIH has held three seminal meetings with the pharmaceutical industry, researchers, and other experts in pain and addiction.
Interagency Pain Research Coordinating Committee
NIH, through the Interagency Pain Research Coordinating Committee, developed the Federal Pain Research Strategy, a long-term strategic plan to coordinate and advance pain research. The Strategy’s research priorities include prevention of acute and chronic pain, management of acute pain, transition from acute to chronic pain, and understanding the disparities that influence pain and pain management. The recently announced NIH-DoD-VA Pain Management Collaboratory is investing $81 million to implement cost-effective large-scale clinical research in military and veteran healthcare delivery organizations, focusing on non-medication approaches to pain care and other comorbid conditions, reflects progress in implementing the Strategy.
Research to Inform Clinical Practice
Many states, health systems, and healthcare professional organizations are implementing policies that reduce opioid prescribing and encourage non-opioid options, which will improve long-term pain treatment and outcomes. HHS agencies are funding research to evaluate the effectiveness of these policies, identify any unintended consequences, and disseminate information on what works. This research will help to ensure that policies are evidence-based and that patients are able to access the care they need.
Significant efforts toward patient-centered solutions are being made each day across HHS with the goal of reducing opioid abuse, addiction, overdose, and deaths while addressing the challenges that exist in the lives of individuals living with chronic pain. HHS is committed to bringing the full extent of its expertise and resources to bear in this fight.
By working in partnership with our state, local, and nongovernmental partners to build collaborations, share best practices, increase awareness, expedite relevant research, and encourage innovation, we can turn the tide and restore the lives of the millions of Americans touched by the opioid crisis.
Emigré a los Estados Unidos desde Brasil cuando tenía 13 años. Mi papá trabajaba para una compañía estadounidense y lo transfirieron a Washington, D.C. Mi madre dirigía un clínica de salud local y se convirtió en gerente del George Washington Hospital.
Siempre supe que quería ayudar a las personas. Primero, quise ser médico. Pero en la universidad comencé a aprender sobre el campo de la salud pública. Desde mi primera clase de biología, me sorprendí con el impacto del VIH/SIDA en la sociedad, primero desde la perspectiva científica, y luego desde el punto de vista del impacto cultural y humano en los países altamente afectados.
Me encantaba viajar. Después de conseguir mi máster en Salud Pública, trabajé para la Organización Mundial de la Salud y me fui a Angola. Estaba fascinado con llevar asistencia a donde más se necesitaba. Las condiciones eran espantosas: el VIH/SIDA estaba en aumento y las personas luchar contra la violencia y el abuso– inclusive minas de tierra– para obtener ayuda.
Estábamos ofreciendo a las personas acceso a la salud durante una epidemia sin control de IH/SIDA, en el momento en que el estigma era realmente alto y las personas no confiaban en nadie. Nunca olvidaré la lucha de los angoleños.
Trabajé en Afganistán durante algunos años, primero en un proyecto de planificación familiar y más tarde dirigiendo un proyecto de investigación sobre el acceso a la atención médica privada. Aprendí luego de varios bombardeos en los que escapé por muy poco, que había límites para lo que yo podía hacer en un entorno inseguro. Las presiones por mi seguridad se convirtieron en una carga y una barrera para realizar el trabajo en las comunidades que más lo necesitaban.
En 2008, me alegró volver a reunirme con mi esposa y volver a casa a Washington, D.C para sentar base en la oficina global de Recursos para la Salud y Administración de Servicios en el HHS.
Comencé a trabajar en el PEPFAR, el Plan de Emergencia para la Mitigación del SIDA del Presidente, y he trabajado en este programa desde entonces. PEPFAR significa dar lo mejor que el gobierno tiene para ofrecer, al contar con diferentes agencias trabajando juntas para ayudar a los países más afectados por el brote de VIH/SIDA. Muchos de estos lugares tienen poquísimos recursos para enfrentar una epidemia.
Con HRSA, participé de una misión para ayudar a las personas a obtener acceso al tratamiento del VIH en Sudáfrica, Uganda, Nigeria, Tanzania y Botsuana. Trabajé con las poblaciones más vulnerables, incluyendo a personas transgénero, hombres que tienen sexo con hombres y trabajadores sexuales.
Hubo un pequeño desvío en 2011, cuando renuncié para que mi familia pudiera mudarse a Nicaragua donde la USAID había asignado a mi esposa. Allí, continué mi trabajo con el PEPFAR para el Departamento de Defensa, trabajando con el ejército local. Luego nos enviaron a Guatemala, donde fui coordinador del PEPFAR regional para América Central. Allí trabajé con siete países para apoyar a las poblaciones más vulnerables afectadas por el VIH/SIDA. Cuando finalmente regresamos a los EE. UU. en 2016, volví al HRSA a la oficina de VIH/SIDA y continué trabajando en el programa PEPFAR.
Siempre estoy aprendiendo de cada misión que tengo, en el campo y en la sede central. Y he aprendido mucho sobre cómo funciona el PEPFAR.
El PEPFAR tiene un impacto muy grande, ya que llega hasta donde más se necesita, colaborando con los países huéspedes y compartiendo mejores prácticas. El HRSA trata de la misma manera a sus socios esenciales a nivel nacional y a aquellos a nivel internacional. La misión del HRSA es mejorar la salud de los estadounidenses, y tiene el mismo énfasis a nivel nacional que el PEPFAR tiene internacionalmente, trabajando con las poblaciones vulnerables, la salud rural, los bajos ingresos y la necesidades de construir una fuerza laboral e infraestructura de salud.
Siempre que me siento frustrado a causa del trabajo, recuerdo que las personas que viven con VIH tienen que luchar todos los días con el estigma y la discriminación que sufren, e incluso con la violencia y el abuso. Siempre pongo las cosas en perspectiva y eso me da fuerzas para seguir adelante. Me encanta este trabajo, y quiero continuar ayudando a las personas tanto como pueda.
Soy Rodrigo Boccanera, trabajador de salud mundial y oficial del programa HRSA. Y yo soy HHS.
Rodrigo es una de las 79,000 personas que hacen que el HHS funcione todos los días. Puede compartir su historia y ver otras en Twitter y Facebook con el hashtag #IAmHHS.
Dr. Walter Koroshetz, director of the National Institute of Neurological Disorders and Stroke (NINDS), goes on the road to Milwaukee next month to talk to scientists and their business partners about the $980 million in seed money at HHS—mostly through NIH — available for aspiring small businesses with innovative ideas for promising life-saving technology.
“We think there are longstanding benefits to our country. The more kinds of people you can get involved, the better we can fulfill our mission,” Dr. Koroshetz said, adding that the diversity of ideas is critical, particularly to good science.
“One can not predict where the next great idea will come from. We want to find the best science,” added Stephanie Fertig, director of NINDS small-business programs. “We want to increase representation of those who have been under represented.”
The Milwaukee conference, where Koroshetz will be the key note speaker, brings together hundreds of small businesses with program managers at NIH, as well as the Food and Drug Administration, the Centers for Disease Control and Prevention and NASA. The seed money in question is through Small Business Innovation Research (SBIR) and Small Business Technology Transfer (STTR) grants and contracts. There are 11 federal agencies with SBIR programs, of which five also have STTR programs. The SBIR and STTR programs created by Congress in 1982 and 1992, respectively, are coordinated by the Small Business Administration. The overall combined federal SBIR and STTR programs have $2.5 billion available to small businesses.
The seed money is allotted for small aspiring businesses with innovative ideas for promising life-saving technology.
The HHS SBIR/STTR programs are a key source of capital for small American businesses that are trying to create innovative, life-saving technologies to improve health but are too young to acquire capital through traditional financing. This early stage capital, and rigorous NIH vetting to qualify for the grants, help the small businesses obtain the data to show the feasibility of their products—and eventually attract attention from other financial backers and larger biotech companies, Fertig said.
Koroshetz sees it like a two-part process: He says NIH has robust programs to recruit minority and women scientists, and, then through SBIR grants, helps those with an entrepreneurial bent to get their businesses off the ground.
“To get the science to the patient, there has to be a handoff to a commercial entity These grants help get science out of the lab,” he said.
Meetings such as the annual NIH SBIR/STTR conference, the national SBIR Road Tour and vendor conferences hosted by OSDBU give aspiring small businesses valuable opportunities to network with federal program specialists and learn about government grant and contracting opportunities.
During fiscal 2017, OSDBU hosted 537 small businesses – 309 of which were designated “Small Disadvantaged Business” and/or “HUBZone” – at its vendor outreach sessions, which provide companies the opportunity to discuss their capabilities with HHS small-business specialists. OSDBU also hosted four events in Maryland, Washington State and Alabama, which included workshops and counseling sessions with HHS representatives, large prime contractors, and other federal agencies.
One small minority firm noted in a letter to OSDBU that learning how to do business with HHS during one of the vendor conferences last year helped the company secure a three-year contract. The company president wrote: “We have experienced government agency networking at its best.”