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The Biggest Threats to Public Health Opioid Abuse, Anti-Vax Movement, Antibiotic Resistance Loom Large By CINDY SANDERS

of the list,” stated Schaffner. Opioid addiction William Schaffner, and misuse have been MD, a professor of mediwell documented across cine in the Division of all socioeconomic levInfectious Diseases and els, ethnicities, reliof preventive medicine in gious beliefs and ages. the Department of Health While some areas of the Policy for Vanderbilt Unicountry have been hit versity School of Medicine, harder, no community has devoted his career to has escaped the crisis. public health and disease Statistics from the Naprevention. A Yale gradutional Institute on Drug ate and Fulbright Scholar, Abuse show just under he earned his medical 17,000 deaths from drug degree from Cornell Unioverdose in 1999. By versity and completed his 2017, that number had fellowship in infectious disjumped to 70,237 with ease at Vanderbilt before Dr. William Schaffner, a noted authority on public health and infectious disease, 47,600 of those overdose being commissioned in the frequently speaks on his field of expertise. deaths involving opioids U.S. Public Health Service in some form. as an epidemic intelligence In addition to the immediate human service officer with the Centers for Disand international media outlets on a range toll caused by misuse, Schaffner said there ease Control and Prevention in Atlanta. of public health topics. Recently, during a are far-reaching consequences that are After completing his tour of duty with the break in a CDC meeting he was attending, only beginning to be understood. Opiate CDC, he returned to Nashville and the Schaffner took time to speak with Medical addiction, he continued, has a wide range faculty of Vanderbilt. News and share thoughts on his three top of downstream implications from family Schaffner, who sits on numerous napublic health threats. disruption to increasing a user’s risk for tional committees and is a current board an array of infectious diseases. The latter, member and past president of the NaThe Opioid Crisis he noted, has caused ethical dilemmas for tional Foundation for Infectious Diseases, “The crisis regarding opioid use and providers and payers. has become a ‘go to’ expert for national abuse … that’s got to be right at the top

In particular, Schaffner pointed to a spike in infective endocarditis, an infection of the interior heart lining, that has been attributed to opioid abuse. The heart infection can be treated with antibiotics or through surgery, depending on severity and response to medication. However, treatment is very expensive … but failure to treat is fatal. Adding to the conundrum is the very real chance the infection could reoccur with continued drug use. “It’s also true that many of these people don’t have any insurance or insufficient insurance, and so this creates a financial stress on the institutions – the hospitals,” Schaffner said of covering treatment options. “This has precipitated the creation of ethical committees who try to interact with the patients who are affected,” he continued. Schaffner noted these committees have, in many cases, agreed to one surgical treatment if required … but only one … and that the patient must agree to go into a drug treatment program as a condition of having the surgery. Schaffner said these programs were created out of desperation and compassion, but “nobody has really had a chance, yet, to evaluate how successful the programs are.” (CONTINUED ON PAGE 12)

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