Dr. Greg Murphy, a State Representative, physician, and surgeon from Greenville, N.C., talks about the opioid epidemic and what the North Carolina General Assembly is doing to combat it.
INTRODUCTION: Thanks for joining us this week for Family Policy Matters. Today, we are going to be discussing a national ranking that has placed North Carolina atop an unfortunate list of states battling a widespread epidemic of opioid drug abuse. Our guest today is State Representative Dr. Greg Murphy, a physician and surgeon from Greenville, North Carolina, who is serving in his first full term in the North Carolina House. Representative Murphy serves as chairman of the House Health Committee and the Appropriations Committee on Health and Human Services. He is also a primary sponsor of an important piece of legislation designed to address the opioid crisis in North Carolina, HB 243, which is entitled the Strengthen Opioid Misuse Prevention Act, or STOP Act, to use the acronym. Rep. Murphy, welcome to Family Policy Matters. It’s great to have you on the show.
GREG MURPHY: Thank you very much for having me here.
JOHN RUSTIN: Rep. Murphy, for the benefit of our listeners as we begin, I’d like to ask you just to introduce yourself and tell us briefly how you decided to go into medicine and what led you to become a member of the North Carolina General Assembly?
GREG MURPHY: Thank you. I actually started thinking about medical school when I was very young. My father was a physician. He did not practice much but that’s actually what started the conversation and academically, that’s the field that I pursued. I studied pre-medicine work in college, also with religion, and my first dealings with medicine actually came not in the US but actually outside the US, when I did my first mission trip some 30 years ago serving in a leprosy hospital in northern India. I met Mother Teresa at that point in time and that was really a changing point in my life. I was trying to decide whether I wanted to be a long-term medical missionary. I since have really decided to do medical mission work long term, having served in places all over the world—Africa, India, Haiti, Nicaragua—several other countries. That brings me to where I am now. This political arena was never something that was ever on my radar. And I believe honestly, as I have said in other venues, it was a spot that came available and after several months of saying, “No,” my wife literally grabbed me and said, “Is this your plan or God’s plans?” In some ways serving in Raleigh is really doing mission work here. It’s taken me away, sadly enough, it’s taken me away from a lot of the medical mission work that I have done. I still stay in touch primarily with folks in Haiti and Nicaragua with whom I’ve worked for many, many years. But this is why I’m serving here in Raleigh. I believe it’s important that we have a voice for medicine, for patients, and for those who take care of patients in our state legislature.
JOHN RUSTIN: That is great and I think our listeners can clearly understand your history and your heart. Let’s shift our attention now to the incredible opioid epidemic in North Carolina. Just as we begin, explain what we mean when we talk about opioids. What are these drugs?
GREG MURPHY: An opioid is a chemical compound that is generally prescribed or synthesized illicitly to illicit a response that either blocks pain or illicits euphoria. In the illicit sense—where they are not legal—it’s generally a euphoric sense that people take opioids or synthetic opioids. But generally, they are a pain medication, something that helps with acute pain or even chronic pain.
JOHN RUSTIN: According to a recent report, Wilmington actually leads the nation with the highest opioid abuse rate in America, and Hickory, Jacksonville, and Fayetteville, North Carolina, aren’t far behind. How serious and widespread is the abuse of these drugs in our state?
GREG MURPHY: It is a tragic, tragic problem in our state. Four individuals in the state of North Carolina die every day from an opioid overdose. One in one hundred babies is born to an addicted mother, and it is a tragic problem that has been growing and now we are seeing more people die, more people die in the United States last year from overdoses from opioids than died at the height of the HIV epidemic. North Carolina is one of those center states and we’re taking the bulls by the horns and trying to reverse this.
JOHN RUSTIN: That is probably a surprise to many of our listeners to understand that this issue is so problematic and so prevalent across the state. How did we get here? What has caused the proliferation of opioid abuse in our state and across the nation?
GREG MURPHY: I think that is an excellent question. About twelve to fifteen years ago, I can’t remember exactly when, there was a study out by one of our major journals in the United States that actually criticized physicians for not treating pain well enough. In that interim, pharmaceutical companies have come up with essentially very, very potent opioids. And in some of the instances, we’re now taught in the hospital—I’m a surgeon—that the fifth vital sign is pain and that people try to make people comfortable and not be in pain. So I think, it altogether starts as a good cause. The problem is that we are as physicians and other prescribers, we have been overprescribing to try to get that pain taken care of but these new drugs are so highly addictive. So, it’s a one-two punch. We have too many pills out there and these pills now are highly addictive where folks are getting hooked on them. Eighty percent of folks who are die of overdoses actually started out on prescribed medications. So it’s a tragic problem and what happens is that folks from different walks of life get hold of pain medications either from a hurt shoulder or hurt back etc., and in some instances folks are genetically susceptible to an addiction, and through no fault of their own, they don’t set out to be an addict, they don’t set out to seek and to take illicit drugs but they turn to that after they can’t get prescribed medications anymore. So, it is a major major problem and one that affects all facets of life. I have known five young men personally, that my kids went to school with or in Scouts or some other arena, who have actually died from opioid overdoses. These are good people. They are good families. They are not people who have any history of abusing medications but they just get sucked in and it’s tragic.
JOHN RUSTIN: Is there a typical demographic of individuals who are abusing these drugs or does the addiction problem cut across demographic lines?
GREG MURPHY: John, it cuts across all demographics. It cuts across socio-economic barriers. This is a problem of our entire society, not just one segment of our society.
JOHN RUSTIN: As I mentioned at the beginning of the program, you have filed a bill, House Bill 243, that is aimed at curbing this epidemic. Presently, the bill has 75 co-sponsors in the House and 18 co-sponsors in the Senate for the Senate version of the bill. Talk about the bill and explain what it would do. What is it intended to address?
GREG MURPHY: I think first, I’ll talk about the process, and the process in my opinion is how government is supposed to work. It was a bipartisan-supported bill. Also not just legislators were involved. The Council of State, the Attorney General and the Governor were involved. And this is because we all recognize that this is a horrible problem, not only nationally but really for our state. What the bill does, essentially, it requires the folks who actually prescribe the medications—there are now laws to say, this is how many days worth of medication are allowable for certain disorders, for acute pain, for post-surgical pain, for example. Patients that I operate on were given a little bit more leeway. We have seven days of medication, where the other one has five. We are strengthening up a system called the CSR system, Controlled Substance Reporting system, to make it a fact that we’re gonna need to prescribe the vast majority of these medications using computer online rather than pads because pads are stolen. They’re fraudulently used. They’re also getting our pharmacists and dispensers involved to work with that CSR system, so we know where drugs are being prescribed and I can look and see if a patient has been prescribed this medication by another doctor recently. So there’s no doctor shopping. We are also trying to work with the budget to get 20 million dollars over the next two years. We’re looking at the folks who prescribe them to try to cut back the number of pills. By the way there were 700 million narcotic pills prescribed in the state of North Carolina last year—700! But, we’re also trying to look at the folks who have been in the unfortunate instance where they are addicted, and try to get substance abuse treatment and community support in those regards. So, we’re really trying to cover the whole gambit. This is the first in, what I believe, are gonna be six or seven bills to try to attack this.
JOHN RUSTIN: Thank you for your leadership on that. In addition to encouraging their legislators to support legislation like this, what can citizens across the state do to help protect their families, their children, their communities from becoming victims of this drug epidemic?
GREG MURPHY: I think that’s a very good question. There are lots of different answers for it. If you’re injured, narcotics oftentimes are the right things to do. But sometimes they’re not needed. And patients have a full right to refuse them, just not get the prescription filled or whatever. Obviously, if there are extra pills left over, those need to be disposed of. They do not need to be flushed down the toilets. We’re working with sheriffs’ departments and they have places where you can drop off pills. We’re also going to start working with some pharmacies and see if you just can’t have a take-back program where those are then taken to the incinerator and disposed of. We’re also working with our Hospice and palliative care community because, often at the end of life, there are a lot of pain medications around and that’s to try to make people at the end of life comfortable. We’re trying to work with them, the Hospice folks, to help gather or help provide information to families how best to get rid of these medications. The bottom line is the opioids have their use in pain management but the extra pills don’t need to be around. And we want to get them out of the equation.
JOHN RUSTIN: I think that’s such an important point and something that our listeners I’m sure are interested in. But considering how they may play a role in this, I think it is so important to stress the necessity of disposing properly of those leftover drugs. Again, I have heard—and I’m sure you’ve heard many more stories than I—about the lengths that individuals will go to find drugs, those who are addicted. Describe a couple of those situations that you are aware of.
GREG MURPHY: I’ll give you an instance of that. Just to give a little bit of background: Oftentimes these start out with Percocet, pain medications or Oxycodone. And when they no longer can get these, this is when folks turn to Heroin or Fentanyl. And the problem is, Heroin is one of the most addictive substances on the Earth and Fentanyl is right there with it. These folks, once they’re addicted to this, it is a craving that’s exceedingly difficult to turn down. And they will go to any length to try to get this medication. About three months ago, I had a kid I operated on, a very nice young man, I believe he was 17, that shared with me after I operated on him and wrote a prescription, that he received a text from one of his fellow classmates: “What did the doctor give you?” In other words, it’s in the schools. These kids are trying to find out what other medicines and they’ll go to any length to try to get these medications. It is a problem and we need to take our heads out of the sand because it is killing, as I said, four North Carolinians every day. I’m hopeful that now that we, as a public, have recognized this issue that we’re going to be able to turn the tide back because it’s killing our youth! It’s killing our youth!
JOHN RUSTIN: It’s certainly an issue that’s going to require the attention of all the citizens of the State and we are grateful for the leadership role that you have assumed here in the North Caroline General Assembly to seek a remedy or a variety of remedies for this. As you said, there may be several different bills that come forth, that make their way through the General Assembly to address different facets of this issue. Is there anything else that you would like to tell our listeners on this subject?
GREG MURPHY: I think it’s a tragic thing but I think it’s a wonderful thing that all facets of our community and segments of our society are rallying around. And it’s good to have these things in government because now with government and legislators—becoming so partisan, we need things that we can actually agree on to help kind of lead us in other avenues to help us seek more agreement in other issues. So, while this is a tragedy, I also think it’s a call for everybody to get together behind certain issues.
JOHN RUSTIN: Right. We just want to encourage our listeners to be very mindful of this. Keep your eyes and ears open for the progress of this and other legislation dealing with this issue. And really, seriously consider what we talked about today and take the necessary steps if you, or someone in your family, someone you love or care about, has been prescribed this kind of pain medication. They may have finished their use of that but have pills left over, that they seek a proper and appropriate way to dispose of that.
GREG MURPHY: That’s by contacting their local police department or their local sheriffs’ department. That’s the best way we have at the present time to do this. I will emphasize just one other thing John: These are not bad people, they’re not bad people. They have been controlled by an exceedingly addictive substance and they need our thoughts, they need our prayers and support, not our condemnation.
JOHN RUSTIN: With that, we’re just about out of time for this week. But before we go, I just want to say thank you so much to Representative Greg Murphy for joining us on Family Policy Matters. We do greatly appreciate your leadership on this important legislation and are thankful for your great work that you and many others in the state legislature do on behalf of the families and the citizens of North Carolina. Thank you so much.
GREG MURPHY: God bless.
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