At Penn, Biden and Bush say United States must change its culture of opioid dependence

Penn Presidential Professor of Practice and former Vice President Joe Biden addressed a sold-out audience and held a conversation on the opioid crisis with Penn President Amy Gutmann at Irvine Auditorium on Thursday. 

Biden was joined by fellow Penn Presidential Professor of Practice and former Florida Governor Jeb Bush, Mayor of Philadelphia Jim Kenney, Penn professor of emergency medicine Jeanmarie Perrone, and Harvard professor of psychobiology Bertha Madras. 

The experts stressed the severity of the nationwide opioid crisis, clarified the benefits of decriminalizing addiction, and the need to change the country's culture to reduce dependence on such drugs.

Gutmann introduced the event by labeling the opioid epidemic as the "deadliest drug crisis in American history," declaring that "no family is immune" and that the crisis "cuts across all communities and affects every corner of society."

Biden decried the overprescription of opioids by American doctors and the "greed" of drug companies. He stated the death tally from the current opioid crisis is larger than the American death toll from the Vietnam War.

"What we're seeing in an emergency room now is picking up the pieces of the 220 million prescriptions," Perrone, who is also a Penn emergency department physician, said.

Explaining why government has failed to deal with the opioid crisis, Biden said many politicians believe addiction is a matter of willpower, leading to a lack of funding for opioid prevention policies.  

"It's a disease — it's a disease of the brain," Biden said, refuting what he said was a widespread misconception.

Madras agreed, stating addiction is a bio-behavioral disease that leads to compulsive use of drugs, and that many people cannot simply "climb out of that uncontrollable urge."

In the face of Philadelphia's opioid crisis, Kenney said the city learned to decriminalize addiction. In order to combat the epidemic, he said Philadelphia launched the Resilience Project, which includes treatment facilities.

"We don't want to lock people up, it makes things that much worse," Kenney said. "I think we have to do a whole lot more of that diversion in order to have some impact."

The experts discussed treatment options for opioid addiction and solutions for the crisis, with the doctors describing medical solutions and the politicians proposing legislation and government action. 

Perrone praised the "tremendous helpful" that drugs like Buprenorphine and Methadone do to stabilize the brain.

Madras analyzed the three stages of opioid demand reduction: prevention, intervention, and treatment. 

"We have to understand that a lot of this begins at home and families," Madras said.

"It's not cool to take drugs in general," Bush said, mentioning the intersection of mental illness and addiction in terms of his daughter's struggles.

During his time as governor of Florida, Bush implemented drug courts and drug treatment facilities across the state, a move he described as an incredible success.

"This is a national challenge. If we marginalize it to the most vulnerable amongst the people we see on the screen, we miss the point," Bush said.

As the conversation transitioned to the role of illegal drugs, Kenney broadened the conversation to China, where he said most fentanyl originates from. 

To stem the flow of drugs passing through the border, Biden proposed negotiating with the countries in question and implementing consequences for non-cooperation, as well as hiring additional personnel at legal ports of entry.

"I'm relatively optimistic and confident," Bush said, expressing hope for a decrease in the pain caused by the opioid crisis. "You're seeing a decline in prescription drugs."

As Gutmann asked what each panelist wished Americans would understand about the crisis, Bush said he wanted "to change our culture so that we don't default to taking a pill to solve our problems."