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‘A 737 crashing every single day’

OPIOID IMPACT — Dr. Rahul Gupta, West Virginia Public Health commissioner and West Virginia Medical Association president, spoke Thursday to the Hancock County Medical Association about the opioid epidemic and how environment and socio-economics impacts health and addiction. -- Summer Wallace-Minger

OPIOID IMPACT -- Dr. Rahul Gupta, West Virginia Public Health commissioner and West Virginia Medical Association president, spoke Thursday to the Hancock County Medical Association about the opioid epidemic and how environment and socio-economics impacts health and addiction. -- Summer Wallace-Minger

OPIOID IMPACT — Dr. Rahul Gupta, West Virginia Public Health commissioner and West Virginia Medical Association president, spoke Thursday to the Hancock County Medical Association about the opioid epidemic and how environment and socio-economics impacts health and addiction. — Summer Wallace-Minger

WEIRTON — Dr. Rahul Gupta, West Virginia Public Health commissioner and West Virginia Medical Association president, spoke to a group of Hancock County medical professionals about the changes in medicine over the last 100 years, how a patient’s environment and socio-economic status can impact their health and the opioid epidemic that kills 50,000 Americans each year.

“That’s like having a Boeing 737 crashing every single day of the year,” he said, adding that someone died of a drug overdose every 12 hours in West Virginia on average.

In the past 100 years, life expectancy has grown by approximately 30 years, and only five of those can be credited to advances in medicine, while most are because of public policy establishing standards for quality of drinking water and food, establishing sanitation and requiring immunization. The most frequent causes of death 100 years ago were communicable diseases. Now, they are chronic illnesses usually caused by lifestyle choices, such as diabetes, hypertension and kidney disease.

The most important indicators to a person’s health are their level of education and economic stability — the more educated and well-off a person is, the more likely they are to be healthy. Other important factors include access to quality housing and transit, support from family and community and general safety of a neighborhood. Access to health care and quality of health care account to about 20 percent of overall health, according to studies.

“Where you learn, play, pray and work matters,” Gupta said.

West Virginia has one of the highest rates of poverty and lowest percentage of adults continuing their education, specifically obtaining a bachelor’s degree.

Most health problems can be traced back to two sources: Obesity and smoking, and reducing these two factors will reduce the amount of money spent on programs such as Medicare, Gupta said.

West Virginia is the most obese state in the country, and this change has come about in the past 30 years — in 1990 data, West Virginians were in keeping with the national average. However, as the country as a whole trended more obese, West Virginia was ahead of the curve.

“This is not something that happened overnight,” Gupta said.

Gupta discussed different factors that correlate to increased obesity, including a lack of physical activity. An increased reliance on automotive transportation, instead of walking or biking leads to a more obese population, as does the time spent on preparing and eating food. However, Gupta explained those who take longer to prepare and eat their food are less obese than those who take less time. He suggested this was because of a fast food culture that puts an emphasis on spending more time on work and activities outside the home, resulting in poor food choices.

The state recently completed a study on reducing childhood obesity, Childhood Obesity Intervention Cost Effectiveness Study, with the Harvard School of Public Health. Among the recommendations was encouraging the development of hiking and walking trails in communities throughout the state and increasing the availability of fresh fruits and vegetables through farmers’ markets with the “Try This, West Virginia” program.

West Virginia has made strides in increasing the number of children who have never smoked a cigarette. Roughly three-quarters of middle schoolers and half of high schoolers have never smoked, according to recent data.

“This (low smoking rates among children) is good news for us,” Gupta said. “These kids will grow up and probably not be smokers.”

If someone doesn’t pick up smoking by high school or college, they are unlikely to ever smoke, he said. However, there has been an increase in the number of children using e-cigarettes, and adult smoking remains steady and it is estimated one in two pregnant mothers smoke.

“In the southern counties, (the rate) is probably worse,” Gupta said.

There has been a 65 cent increase in the tobacco tax, bringing it up to $1.20.

“It does have an impact,” Gupta said.

The opioid epidemic impacts men and women equally, and nine out of every 10 of those addicted are white. Most are adults between 30 to 60 and living in impoverished areas. Most of those addicted received a prescription for opioids and became addicted — 75 percent of those addicted originally were prescribed an opioid. Those who have been prescribed an opioid are 40 times more likely to become addicted to heroin than those who have not.

“I hope that we, as medical professionals, understand that (addiction) is a chronic, relapsing condition,” Gupta said.

West Virginia has the highest rate of addiction in the country, more than a third more than the next two states on the list. Gupta said a significant number of those addicted are using heroin, fentanyl or carfentanyl — fentanyl is 100 times more potent than morphine and carfentanyl 1,000 times more potent. Benzoids also are frequently being mixed with opioids. Gupta noted that, in the past, many of those who overdosed had one or two types of pharmaceuticals in their systems, and, now, it can be as many three to five.

“It is polypharmacy,” he said. “They are being prescribed multiple (prescriptions).”

Gupta showed a series of maps to the group, showing the correlation between poverty and opioid addiction across the country and the state.

To address the public health crisis, Gupta said lawmakers have made naxolone, used to treat overdoses, available over the counter; enacted good samaritan laws to encourage those with someone suffering from an overdose to call emergency services without being at risk for arrest for possession; vetted pain clinics and established a prescription watch; encouraged overdose training for first responders and harm reduction programming at a local level; and established an addiction hotline at (844) HELP-WV.

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