Freakonomics Radio

EXTRA: The Opioid Tragedy — How We Got Here

Jun 3, 2024

Jeanmarie Perrone, a professor specializing in addiction medicine at the University of Pennsylvania, and Stephen Loyd, Chief Medical Officer at Cedar Recovery, delve into the opioid crisis. They discuss personal stories of addiction and the importance of harm reduction strategies like Suboxone. Insights reveal how the pandemic exacerbated the crisis and highlight innovative treatment approaches, including the 'warm handoff' method to support recovery. The conversation addresses stigma and the community's vital role in overcoming addiction challenges.

41:59

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Episode guests

Stephen Loyd

Jeanmarie Perrone

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Quick takeaways

Expanding access to addiction treatment is crucial for addressing the opioid crisis.

Buprenorphine offers a less stigmatizing treatment option with potential to reduce overdose deaths.

Deep dives

The Ongoing Opioid Crisis

The opioid crisis continues to persist despite efforts to address it. The episode discusses the evolution of the crisis, pointing out its worsening during the pandemic. Although there are signs of improvement, the crisis has left a devastating impact. The podcast highlights the importance of addiction treatment becoming a universal part of routine medical care. Medical professionals emphasize the necessity of expanding access to addiction treatment.

Intro

2min

Combating the Opioid Crisis: Treatment and Personal Stories

21min

Understanding Opioid Addiction: A Biopsychosocial Perspective

5min

Breaking the Stigma: New Approaches to Opioid Addiction Treatment

5min

Stories of Addiction and Recovery

8min

The Role of Community in Overcoming Addiction

5min

An update of our 2020 series, in which we spoke with physicians, researchers, and addicts about the root causes of the crisis — and the tension between abstinence and harm reduction.

SOURCES:
- Gail D’Onofrio, professor and chair of emergency medicine at the Yale School of Medicine and chief of emergency services at Yale-New Haven Health.
- Keith Humphreys, professor of psychiatry and behavioral sciences at Stanford University.
- Stephen Loyd, chief medical officer of Cedar Recovery and chair of the Tennessee Opioid Abatement Council.
- Nicole O’Donnell, certified recovery specialist at the University of Pennsylvania's Center for Addiction Medicine and Policy.
- Jeanmarie Perrone, professor of emergency medicine at the University of Pennsylvania.
- Eileen Richardson, restaurant manager.

RESOURCES:
- “Toward Healthy Drug Policy in the United States — The Case of Safehouse,” by Evan D. Anderson, Leo Beletsky, Scott Burris, and Corey S. Davis (The New England Journal of Medicine, 2020).
- “Buprenorphine Deregulation and Mainstreaming Treatment for Opioid Use Disorder,” by Leo Beletsky, Kevin Fiscella, and Sarah E. Wakeman (JAMA Psychiatry, 2018).
- “Emergency Department–Initiated Buprenorphine/Naloxone Treatment for Opioid Dependence,” by Gail D’Onofrio, Patrick G. O’Connor, Michael V. Pantalon, Marek C. Chawarski, Susan H. Busch, Patricia H. Owens, Steven L. Bernstein, and David A. Fiellin (JAMA, 2015).
- “Buprenorphine-Naloxone Therapy In Pain Management,” by Lucy Chen, Kelly Yan Chen, and Jianren Mao (National Institutes of Health, 2014).
- “Prevalence and Correlates of Street-Obtained Buprenorphine Use Among Current and Former Injectors In Baltimore, Maryland,” by Jacquie Astemborski, Becky L. Genberg, Mirinda Gillespie, Chris-Ellyn Johanson, Gregory D. Kirk, Shruti H. Mehta, Charles R. Schuster, and David Vlahov (U.S. National Library of Medicine National Institutes of Health, 2014).
- “The Promotion and Marketing of OxyContin: Commercial Triumph, Public Health Tragedy,” by Art Van Zee (U.S. National Library of Medicine National Institutes of Health, 2009).