The opioid epidemic’s cruel evolution

The ideas and innovators shaping health care

Sep 20, 2023 View in browser   By Carmen Paun, Erin Schumaker, Daniel Payne and Evan Peng DANGER ZONE More fentanyl users are mixing it with cocaine or meth, heightening the danger. | AFP via Getty Images America’s opioid overdose crisis has reached a dangerous new stage: People are dying from a combination of the illicit synthetic opioid fentanyl combined with stimulants such as cocaine or methamphetamine, according to a new study by researchers at University of California, Los Angeles. Why it matters: The combination is much deadlier and complicates the public health response, said authors Joseph Friedman and Chelsea Shover. “We need to do better in treating substance use disorder in people that use both stimulants and opioids,” Shover told Carmen. That includes improving access to treatment for opioid use disorder and making naloxone, the opioid overdose reversal drug, widely available, she said. Treatment challenge: While people who use illicit opioids have escaped addiction using buprenorphine and methadone, there’s no licensed medication to help people who use stimulants like cocaine and methamphetamine, Shover said. Shover backs a behavioral therapy known as contingency management that offers small cash payments as an incentive to resist using the drugs. But the therapy is hard to come by because “it’s politically unpalatable to pay people who use drugs to stop using drugs,” she said.   GO INSIDE THE CAPITOL DOME: From the outset, POLITICO has been your eyes and ears on Capitol Hill, providing the most thorough Congress coverage — from political characters and emerging leaders to leadership squabbles and policy nuggets during committee markups and hearings. We're stepping up our game to ensure you’re fully informed on every key detail inside the Capitol Dome, all day, every day. Start your day with Playbook AM, refuel at midday with our Playbook PM halftime report and enrich your evening discussions with Huddle. Plus, stay updated with real-time buzz all day through our brand new Inside Congress Live feature. Learn more and subscribe here.     WELCOME TO FUTURE PULSE Xishan, Kunming, China | Evan Peng This is where we explore the ideas and innovators shaping health care. Octopuses and squid used in research may one day have the same protections as lab rats and monkeys, Nature reports. The National Institutes of Health proposed new guidelines this month to have an oversight board approve research projects on cephalopods — ensuring protocols avoid or minimize "discomfort, distress, and pain" to the animals — before they get federal funding. What ethical research on octopuses looks like, however, is still an open question. Share any thoughts, news, tips and feedback with Carmen Paun at cpaun@politico.com, Daniel Payne at dpayne@politico.com, Evan Peng at epeng@politico.com or Erin Schumaker at eschumaker@politico.com. Send tips securely through SecureDrop, Signal, Telegram or WhatsApp. Today on our Pulse Check podcast, host Lauren Gardner talks with POLITICO health care reporter Erin Schumaker about YouTube’s plans to become an authority on medical information. Listen to today’s Pulse Check podcast THE LAB Some doctors are fretting about AI, others are trying to master it. | Lionel Bonaventure/AFP/Getty Images Future doctors in San Antonio aren't fretting about artificial intelligence's creep into medicine — they're embracing it. After a successful pilot program, UT Health San Antonio and the University of Texas at San Antonio are partnering to offer students a dual degree in medicine and AI. How it works: The five-year program combines a medical degree with a master’s of science in artificial intelligence. Students must be admitted to the program's medical school and complete one year before they're eligible to apply for the dual program. The AI part of the degree will offer three concentration options: data analytics, computer science, or intelligence and autonomous systems. What's next? "I believe the future of health care will require a physician to navigate the technical and clinical sides of medicine," Aaron Fanous, a fourth-year medical student in the pilot program, said in a statement. "The experience opened my mind to the many possibilities of bridging the two fields," Fanous said, adding that he plans to use his dual degree to solve tomorrow's medical challenges.   Enter the “room where it happens”, where global power players shape policy and politics, with Power Play. POLITICO’s brand-new podcast will host conversations with the leaders and power players shaping the biggest ideas and driving the global conversations, moderated by award-winning journalist Anne McElvoy. Sign up today to be notified of the first episodes in September – click here.     WORKFORCE Kaiser workers may walk off the job next month. | Getty Images Tens of thousands of workers at health care provider Kaiser Permanente could strike, the latest sign of turbulence in the industry. In California, Washington state, Oregon, Virginia, Maryland and Washington, D.C., workers have voted to authorize strikes, saying management needs to boost pay and hire more staff to alleviate shortages. Other Kaiser units plan to vote today. Why it matters: The Kaiser workers’ votes come amid an increase in health industry strikes, driven by inflation, staffing shortages, a desire to define post-pandemic workplace standards, and labor unrest in other sectors. But providers are resisting their workers’ demands because broader cost pressures are mounting. Kaiser said in a statement it hopes to resolve negotiations before the Sept. 30 deadline the workers have set. Kaiser also pushed back against some union demands, noting that it has proposed a $21-an-hour minimum wage, hired 9,000 people this year and continues to recruit. Even so: A recent analysis from credit rating firm Fitch Ratings found that wage growth may be leveling out for health workers. In Congress: Liberals on Capitol Hill are lending support. Sen. Bernie Sanders (I-Vt.) attended a National Nurses United town hall last week about nurse-to-patient ratios, and Sen. Tammy Baldwin (D-Wis.) joined a local nurses’ union in Wisconsin to discuss their concerns. Legislators on both sides of the aisle, meanwhile, believe that growing — and retaining — the health workforce is a priority coming out of the pandemic.   Follow us on Twitter Carmen Paun @carmenpaun Daniel Payne @_daniel_payne Ruth Reader @RuthReader Erin Schumaker @erinlschumaker Evan Peng @thepngfile   Follow us

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