Dr. Omar Abubaker (Photo by Allen Jones courtesy VCU)
Adam Abubaker seemed to be back on track. He’d been battling an opioid addiction and was in school for emergency medical services training and working toward a career as an EMT.
His father, Omar Abubaker, a chair in oral surgery in the dental school at Virginia Commonwealth University, was proud of his progress and how he was working to overcome his addiction. But Adam lost his battle in October 2014 and died of an overdose.
His father began to read about addiction and immersed himself in the subject. He realized that he and his peers were part of the problem, over-prescribing pain medication and not considering its consequences.
Adam did not choose heroin, his father says. He thinks his son’s addiction had its origins in the painkillers he was prescribed after minor shoulder surgery for a football injury when he was 17.
“My pain is magnified, because my profession shares some of that burden,” Abubaker says.
Abubaker cited a feature that aired on NPR’s “Morning Edition” on Dec. 1 in which retired U.S. Navy Admiral James Winnefeld talked about his son, Jon, who, like Adam Abubaker, lost his life in an overdose. Both had been athletes. Each were seemingly on the upswing in life: Both had plans to go back to school, to pursue careers helping people. Adam had been a volunteer firefighter and wanted to pursue a degree in emergency medical services; Jon was on track to become an EMT firefighter.
And yet they both succumbed to their addictions.“The similarities are not coincidental,” says Abubaker. “That is where it is tragic; something keeps happening and we keep doing the same things.”
Dr. Abubaker with Virginia Sen. Tim Kaine (Photo courtesy U.S. Senate Photographic Studio)
He’s led efforts since his son's death to change the way professionals are trained at the medical school regarding opioid addiction and in how pain pills are prescribed. He’s also engaged in community outreach efforts, including a Nov. 30 visit to Washington, D.C., where he shared his insights with members of the U.S. Senate’s Health, Education, Labor and Pensions committee. “In Adam’s memory, I have become a foot soldier in the war on addiction,” he told the committee.
Testifying before Congress was both an honor and an obligation, according to Abubaker. More importantly, it gave him a chance to give voice to the grief and concerns of people across the nation who have lost loved ones to opioids.
“I represented hundreds of thousands of fathers who will not speak, because they are suffering,” he says.
In his research, Abubaker realized that there’s no one reason behind the epidemic, and there’s no magic bullet to stem the tide. It’s a coalescing of numerous factors, as detailed in the White House Commission on Opioids report, which “put it together for me,” he says.
VCU has changed curriculum in response to the crisis.
Abubaker notes that until recently it was common for dentists and doctors to prescribe too many narcotic painkillers for patients following surgery without giving thought to alternatives. If you had just pulled three teeth, would ibuprofen work instead of codeine to manage the patient’s pain? If that failed, then should you prescribe one or two opioid pills instead of a bottle full?
Patients need to be informed that just because a doctor prescribes 20 pain pills, they don’t have to take them all, and whatever is left needs to be closely monitored or locked away to keep a child in the house or someone else from abusing them.
“We never talked about this stuff before,” Abubaker says. Now, the emphasis is on dispensing any pain medication minimally and smartly, he adds.
It’s easy to teach students to utilize this paradigm, but it’s harder to get dentists out in the field to change how they’ve been practicing pain management for years. Some may change, but for others, their methods have worked for them for years, and it’s harder to break a longstanding practice.
“The changes in the long term [are] going to be from the younger generation,” Abubaker says. The revised approach is “just absolutely effective, as close to 100 percent as possible.”
Stricter state guidelines regarding opioid prescriptions are also helping, limiting the length of time the medications may be prescribed and the number of tablets dispensed, and increasing the paperwork to monitor their use.
Beyond the classroom, Abubaker takes his message out into the community, meeting with dentists and community groups. He even tries to update students who are about to graduate regarding changes in dentistry board regulations, treating them to pizza and a talk.
“I’m doing that little corner of mine as effectively as possible,” he says.
Abubaker also wants more done to raise public awareness regarding opioids. He’d like to see public service announcements that would help the public better understand brain function and addiction, something, hopefully, to deter youth and educate parents.
“Everything we do may affect only a certain number, but a certain number is good enough for me,” he says. “If there’s one child saved, it’s a 100 percent success rate.”
CAPSULES
A roundup of the week’s health and medicine news
- St. Francis Medical Center in Midlothian and St. Mary's Hospital have earned accolades from the Leapfrog Group as Top General Hospitals. The Bon Secours facilities were two of the four health care facilities to earn the honor, according to a release.
Roberta Tinch
- The new chief operating officer for HCA Johnston-Willis Hospital is Roberta Tinch. She comes to Richmond after serving in a similar position since 2014 at Spotsylvania Regional Medical Center in Fredericksburg.
- A drug that may help reduce the recurrence of overdoses in people coping with opioid addiction is the focus of a clinical trial at Virginia Commonwealth University. The drug is SUBLOCADE, a form of the medication buprenorphine that is injected once a month, according to a release. Trial subjects will be drawn from adults with opioid use disorder who have been treated in the VCU Health emergency room, who will be approached immediately after they recover. Those who agree to participate will be taken to an outpatient clinic, where the drug will be administered and they will meet with a behavioral therapist. “This research could have a major impact on a public health emergency,” says the chief investigator, F. Gerard Moeller, director of the VCU Institute for Drug and Alcohol Studies and a professor of psychiatry, pharmacology and toxicology, and neurology at the medical school. “It would be a new treatment paradigm for patients after an overdose, with the goal of reduction of repeat overdoses and deaths.” The medication is from Richmond-based Indivior Inc., which is a co-funder for the 18-month trial along with the university and the Virginia Biosciences Health Research Corporation.
- A short-term stay unit has opened at HCA Chippenham Hospital. The 20-bed unit is designed for patients who need 23 hours or less observation following surgery or treatment in the emergency room or cardiac catheterization laboratory, according to a release. The unit features semi-private rooms with state-of-the-art technology and allows for patients to visit with family and friends.
- Virginia Commonwealth University researchers studying which people are most likely to seek revenge for a perceived wrong hope to use their results to create profiles that could be used to identify people likely to commit acts of violence and intervene before they hurt someone. “Not everyone when they’re wronged goes out and shoots up a school. Not everyone when they’re wronged starts a bar fight. But some people do. So identifying who is most at risk for seeking revenge is really important to do in order to intervene before they engage in harmful acts and start to hurt other people in retaliation,” says David Chester, an assistant professor of psychology at VCU. He worked with the University of Kentucky’s C. Nathan DeWall on the project, and the results will be published in the journal “Aggressive Behavior.” They drew their subjects from Kentucky students and found that sadism was the dominant personality trait in those interested in seeking revenge. “The core of what we found is that the person who seeks revenge is a person who tends to enjoy it,” says Chester in a release.
