Understanding the Opioid Epidemic with Dan Ciccarone

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The opioid epidemic is the greatest public health crisis of our time. It is estimated that about 64,000 people died of opioid overdoses in 2016 – more than died in the Vietnam war or in 1 year at the height of the AIDs epidemic. Dan Ciccarone, our guest this week, and a Professor at UCSF School of Medicine, has spent his career trying to improve our understanding of substance use disorders and their health consequences. He and his collaborators look at this question both up-close, through ethnographic research in the community, and hours and hours of interviews with people who use injection drugs, and also by stepping back and sifting through huge datasets, looking at the larger epidemiologic and economic forces shaping the epidemic. He has spent years studying heroin specifically, and is currently the PI of the Heroin in Transitions study, which continues this vital work.

We talk specifically about a study led by one of his collaborators, Dr. Sarah Mars, “Every ‘Never’ I Ever Said Came True”: Transitions from opioid pills to heroin injecting; his group’s study of trends in hospitalizations and what that tells us about the epidemic in a 2013 Plos One publication, Intertwined Epidemics: National Demographic Trends in Hospitalizations for Heroin- and Opioid-Related Overdoses, 1993–2009. We also discuss his recent look at some of the larger factors influencing the epidemic with collaborators Nabarun Dasgupta and Leo Belitsky in Opioid Crisis: No Easy Fix to Its Social and Economic Determinants.

You can find more information about the book Dr. Ciccarone mentioned, Dreamland by Sam Quinones, here. And you can find the American Society for Addiction Medicine’s waiver training here.

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This interview has been lightly edited for length and clarity. Photo courtesy of Dr. Ciccarone.