RICHMOND, Va. -- Addressing a crowd of medical students at VCU on Monday, Virginia Governor Ralph Northam said in many cases "addiction starts with prescriptions," and urged the students to carefully analyze a patient's medical history before prescribing them pain killers.
Northam's "grand lecture" was the latest in a series of talks at Virginia medical schools that cover the role doctors play in the opioid crisis.
More than 1,200 people died from opioid overdoses in Virginia in 2017.
Northam, a pediatric neurologist by trade, said addiction is a chronic disorder, and physicians in Virginia should treat it as such. The Governor told the students a patient's genetics could predispose them to addiction.
A patient's medical and personal history should serve as the road map for treatment, especially pain management, Northam said.
"[Addiction] starts with prescriptions many times," Northam said. "Always try to look at the full picture, and not just the pain they are coming in with."
Northam introduced Ryan Hall, a Covington resident and son of a local sheriff, who became addicted to heroin after taking opioids a doctor prescribed him to help manage pain from a high school football injury.
"What could we have done that could have helped prevent you from addiction and turning to the street?" Northam asked.
"There has to be a better way to wean people off of medications," Hall said. "You give someone a certain milligram for a certain period of time, and then you go back for your check up and they don't write you the prescription anymore. You're sick, so you turn to other ways."
Carrie Shadowen, a second-year medical student at VCU, said she had learned about the impact opioids have on the body, but working with patients firsthand at VCU's MOTIVATE Clinic, an outpatient facility for people struggling with addiction, was "mind boggling." Shadowen, who grew up in Central Virginia, said she had no idea how extensive the issue was here.
"A lot of people got started through their physicians because of pain management, and then progressed to other street and illicit opioids," Shadowen said. "We need to focus on harm reduction strategies because just telling people they need to stay sober and quit using is not helpful."
After meeting dozens of people struggling with addiction like Hall, Shadowen said doctors need to realize addiction is a chronic medical issue and not a shortcoming with a specific patient.
"Looking at the person in front of you, and seeing what are the pain management options for this person, and what would best serve the symptoms that they have and all of the other factors they are presenting," she said.
