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Q+A: Alzheimer’s Disease, Opioids and the 2016 Election

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With the Democratic National Convention upon Philadelphia, media organizations are hosting events throughout the city to put experts and thought leaders in the same room with lawmakers and journalists.

Health care is a hot issue this election season, with Republicans looking to repeal — or at least refine — the Affordable Care Act, and Democrats hoping to expand it. Two Drexel University professors will get in on the action this week as they discuss the state of health care in 2016 and how the upcoming presidential election could shape its future.

Carol Lippa, MD, a professor in the College of Medicine, joined a panel of experts and legislatures Monday afternoon for a forum on Alzheimer’s disease at Field House, 1150 Filbert Street, in Philadelphia. The forum is part of a series of DNC events hosted by The Atlantic. At Drexel, Dr. Lippa is leading the A4 Study — a clinical trial taking place at locations across the country to determine if a new drug can postpone Alzheimer’s disease.

Anita Gupta, DO, PharmD, an associate professor in the College of Medicine and vice chair of the Division of Pain Medicine, is representing the American Society of Anesthesiology at various events during the Democratic National Convention. As a pain management expert, her goal is to talk with influencers about how to curb the opioid epidemic in the United States.

Carol Lippa 

What will you be speaking about at the panel hosted by The Atlantic on Monday?
I’ll touch on what doctors can offer patients now to fight Alzheimer’s disease and a snapshot of what the future may look like. Right now we really only have symptomatic treatments, and they can’t begin to match the magnitude of the problem. We do have a lot of things in development research-wise, which could be disease-modifying and slow the course of the disease.

How will the next president of the United States affect the fight against Alzheimer’s disease?
President Obama instituted the National Alzheimer’s Project Act (NAPA) in 2011, which prioritized Alzheimer’s efforts and launched the creation of a national strategic plan to address the disease. It started the wheels turning and appointed the Department of Health and Human Services to oversee the task of how we are going to provide care to all of these people down the road who will need Alzheimer’s-related care. The next president will have to build on that.

It would be nice to see more money for research and government efforts to prioritize drug development for the disease. I would also like to see sort of some kind of organization created that could begin to determine how we would start implementing treatment for Alzheimer’s. If an intervention is discovered, how are we going to use it? It would likely be expensive, so we’re going to need an efficient way of determining who would be a good candidate for intervention and who would most benefit. The government supports Alzheimer’s disease research centers, but I think we need similar centers that could deal with training and the education side of things.

Do you think we will see a cure for Alzheimer’s during your lifetime?
A lot of funding has been put toward understanding the disease enough to treat it, and I think that’s going to yield some meaningful results soon. We’re going to have something that will reduce the likelihood of getting Alzheimer’s or that will delay early symptoms so that the disease does not progress so quickly. I don’t think there is so much hope for people who already have the disease, because they’ve lost so many brain cells. Even if you stop the process, how could you get those cells back?

From your perspective, what other health policy issues will matter the most during this election season?
I think the portability of health care insurance is a really important issue. Say you have insurance through your current employer, and you lose your job. If meanwhile you’ve developed a condition and you need a medicine, when you switch your situation, you don’t want the insurance provider to deny coverage. People have to be able to move around and keep insurance with them.

How does the government shape the direction of scientific research, and Alzheimer’s disease in particular?
I view Alzheimer’s as a bipartisan problem. Everyone knows it’s there, it’s huge and it has to be dealt with. But it is not necessarily at the forefront of important issues on legislatures’ agendas.

For the average person, the problem maybe isn’t that glamorous, because you can’t defeat it. It’s not like breast cancer.

But the truth is that there is a lot you can do to slow memory loss. A healthy lifestyle and diet, and staying mentally active can impact cognition and improve memory. Just because we don’t yet have a medication to completely obliterate the disease, does not mean it can’t be prevented. I think there needs to be increased education and awareness about prevention.

Anita Gupta

What was your role at the Republican National Convention, and how will you be involved in the Democratic National Convention?
I am co-chair of the American Society of Anesthesiology’s Task Force on Prescription Opioid Abuse. As a representative of the ASA, I met with more than 50 health care journalists, bloggers and congressional members during the RNC to spread the word about the Comprehensive Addiction and Recovery Act (CARA). The bill passed the House and the Senate, and was signed by President Obama earlier this month. The legislation would support states in fighting the opioid addiction by funding prevention and recovery programs.

The problem is that the legislation would only offer $100 million per year. So this is a start to solve the opioid crisis, but the fact is that it’s not enough. What I’ve been commissioned to do by the ASA last week and this week is to talk to journalists and policy makers, about the importance of CARA, so that there will be a push for more funding. In order to expand services, there needs to be more money allocated to this issue.

How will the next president of the United States affect the fight against opioid addiction?
He or she will need to expand the funding for prevention, recovery and education, which means pushing CARA forward. It’s great that it’s passed, but it’s just the start. I think really a lot of the focus is getting the education out to providers, youth, family members and first responders. And providing access to recovery is a big thing as well.

What do you think the future of the opioid crisis looks like? Will America be “cured” of its painkiller addiction any time soon?
78 people die every day from opioid overdoses. That number is rising in Philadelphia. With all the efforts that are being done, we’re not making progress.

Heroin is a big problem, but what we’re seeing is that prescription painkillers are really the gateway to getting to other drugs. Fortunately or unfortunately, depending which way you look at it, the fact that addiction is now prevalent in all different socio-economic statuses has really brought a lot of attention to the issue. It’s affecting all kinds of communities. So with this added focus, there is hope that the situation will improve, but it will take a lot of time and effort, and a collaborative approach from many different stakeholders. We don’t want to lose a generation to addiction.

How did we get here? Why are numbers of opioid overdoses rising in the United States?One theory is that there were several opioid products that were approved by the FDA and put on the market in the 1990s. There was also a growing idea that doctors needed to be more compassionate and treat pain. Patient satisfaction scores in questionnaires, for instance, rewarded the physicians who prescribed pain medication.

With a lot of the work in the past few months, things are changing. Federal agencies are taking a really proactive approach. Never in the history of medicine have you seen the federal government step and say we’re going to change this issue the way it has with the opioid crisis. It is really unprecedented to have federal laws in place like this.

You attended the RNC. How much discussion of health care issues was there? What are the implications?
There was very little talk about health care issues. I saw that the Cleveland Clinic had supplemental events in conjunction with the RNC, which attracted a lot of congressional members and health leaders. But at the main convention, there was little conversation about health policy, beyond the need to revise the Affordable Care Act. [Senate Majority Leader] Mitch McConnell did praise the legislation to combat heroin and opioid abuse, along with other bills passed with bipartisan support, which was great. The lack of health care discussion seems to say that a lot of the country is pushing these important issues aside. I anticipate that there will be a lot more discussion in the DNC.

For media inquiries, contact Lauren Ingeno at lingeno@drexel.edu or 215.895.2614.

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