House Minority Whip Steny Hoyer drew parallels on Monday between the way former Surgeon General C. Everett Koop handled the AIDS crisis and the expectations he has for how the current surgeon general, Jerome Adams, tackles the opioid crisis.
Koop during his tenure under President Ronald Reagan sent a mailer to every household that detailed how AIDS is spread, despite facing religious, and political opposition at the time. He also endorsed the use of condoms to prevent the spread of AIDS and HIV and advocated for sex education that focuses on proper use of birth control. Koop’s nomination initially was met with skepticism because he was a practicing Presbyterian who was opposed to abortion and didn’t have public health experience, but he often is cited by politicians on both sides of the aisle who say he was willing to transcend politics to tackle public health issues.
“The surgeon general can make an extraordinary impact,” said Hoyer, D-Md., speaking next to Adams at a forum on opioids at the College of Southern Maryland. “My belief is that surgeon General Adams will do exactly that.”
As an example, Hoyer pointed to a needle exchange program that Adams oversaw as health commissioner of Indiana, a job he held before being appointed surgeon general by President Trump. The program was implemented because of the rapid spread of HIV among Hoosiers who were sharing needles to inject Opana, a powerful prescription painkiller that has since been removed from the market.
The sterile needle program was implemented despite initial opposition from Vice President Mike Pence, who was governor of Indiana at the time and opposed the removal of the state’s ban on needle exchange programs.
Opponents of needle exchange programs often say they could encourage people to continue injecting drugs, but Adams has said they are important to stave off the spread of disease and should be a part of treatment for those who are seeking to recover from their addictions.
Increasing the prevalence of needle exchange programs was not among the 56 recommendations that the president’s commission on opioids listed in its report released this month. The commission, led by Republican New Jersey Gov. Chris Christie, was behind the Trump administration declaring the opioid epidemic a public health emergency. The move didn’t have funding attached because the president said Congress should appropriate the amount.
At the forum in Maryland, Hoyer and Adams were joined by local and state leaders, as well as healthcare providers, educators, and law enforcement officials, who are working to help prevent and treat people with addictions from opioids. Hoyer said he held the forum to gain additional insight into what the state was doing and to find out what providers would need from the federal government, including funding.
In opening remarks, Adams laid out several areas where he thought efforts to the opioid crisis were lagging. One example he cited was lack of treatment for people with addictions. Someone who has been administered naloxone to be revived from an opioid overdose is often then sent to jail or to a hospital, and after they are released they tend to be met by drug dealers lingering just outside the facility.
Having a doctor say they will check in with a patient in four to six weeks, rather than connect that person with treatment, was inadequate, he suggested. He noted that police officers often tell him they have administered naloxone to the same person more than seven or eight times, a phenomenon he said pointed to how addiction was a disease. Jails and hospitals needed to connect people with treatment, he said.
“In both cases we have people with untreated addiction whom we’ve detoxed but haven’t adequately treated,” Adams said.
• This article has been updated to include more information about why senators opposed C. Everett Koop’s nomination.
