James.qxp Sept Oct 2018 web (2) - Page 37



effective advocate for public safety and EMS than Pat.
O’Neal. On behalf of his many friends, colleagues and
employees, we can think of no one more deserving.”
With his oversight responsibility including infectious disease, O’Neal was the DPH point man during the
Ebola scare a few years ago and has had a hand in
statewide trauma care for nearly two decades now.
Earlier this year, O’Neal received the 2018 SellersMcCroan Award. The award is given each year to a person whose work has had a signicant impact on epidemiology and/or laboratory services in Georgia.
“It is an honor to be placed among the names of the
past recipients of this award, most of whom have been
colleagues at one time or another, all of whom have
made signicant contributions to public health,” O’Neal
says. “Every day we have the opportunity to make a difference in the lives of the people in Georgia. That is an
awesome responsibility, and the reason I am grateful for
every one of you and the work you do.”
Despite the awards and success, O’Neal has
remained humble. Upon receiving the Stancliff Award
for Epidemiology back in 2015, “I told the audience
that the only possible reason I could have received
this was because I do what Dr. Cherie Drenzek, state
epidemiologist, tells me to do!”
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SEPTEMBER/OCTOBER 2018
hours— we don’t know what could be around the corner. One need only to consider the Ebola or Zika outbreaks in recent years.”.
He also notes the drug crisis on the minds of anyone
paying attention to public health. “The opioid epidemic is
a public health crisis that reaches deeply into virtually
every community and all walks of life. The prescription
drug monitoring program can help eliminate duplicative
prescribing and overprescribing of controlled substances
and provide a prescriber or pharmacist with critical information regarding a patient’s controlled substance prescription history and protect patients at risk of abuse.”
Some Big DPH Challenges
On any given day, the answer to the “biggest
health problem” question may change. Depending on
who you talk to and when, the answer could be opioids, obesity or something else. For O’Neal, there’s
certainly no easy answer:
“(The) biggest challenge is understanding and
responding to the fact that the U.S. spends the most on
healthcare with some very poor health outcomes. How
do we get ahead of the curve with prevention? In our
global community of constant travel, new cases of infectious disease can become outbreaks in a matter of
Georgia’s Opioid Crisis
The biggest individual challenge may be the opioid
crisis. Addiction or abuse rates are not as high as
cocaine or methamphetamines but the real danger of
opioids is the threat of fatal overdose. Black market opioids are often made with extremely strong ingredients—
most commonly fentanyl, which is a prescribed drug but
often fatal in excess amounts— but prescribed opioids
are often the start of the problem or lead to overdoses.
The total number of opioid prescriptions last year in
Georgia was more than 8 million. Nearly one prescription for every citizen in Georgia.
In order to combat over- or duplicate prescribing,
the state legislature passed a law last year requiring prescribers to consult a database to determine whether
patients have recently lled other prescriptions that
may harmfully overlap. The Department of Public
Health oversees this database. That law went into full
effect in July of this year, requiring doctors to check the
database before prescribing.
“DPH’s primary role in the opioid epidemic is the
management of the Prescription Drug Monitoring
Program or PDMP. The PDMP is an electronic database
used to monitor the prescribing and dispensing of controlled substances,” O’Neal says. “The PDMP can help
eliminate duplicative prescribing and overprescribing of
controlled substances and provide a prescriber or pharmacist with critical information regarding a patient’s
controlled substance prescription history and protect
patients at risk of abuse.”
“The goal of the Georgia PDMP is to reduce the misuse of controlled substances and to promote proper use
of medications used to treat pain, as well as to help
diminish duplicative prescribing and overprescribing of
controlled substances,” said O’Neal.
As is so often the case, because it is so pervasive,
O’Neal’s experience with opioids goes beyond being a
health professional and tilts into the personal. His
nephew overdosed a couple years ago and had to be
revived. During a meeting of the North Georgia
Healthcare Coalition earlier this year, O’Neal noted that
the crisis likely impacts every single family in Georgia.
Besides tracking individual patient records, the
database also allows DPH to monitor areas or prescribers that may be abusing the system. “Additionally,
as with all programs, DPH has the responsibility for collecting and analyzing data and surveillance as it pertains to opioids in Georgia. That data comes not only
from the PDMP, but also from Georgia hospital discharge inpatient and emergency department (ED) visit
data, and DPH Vital Records death data.”
Biggest Healthcare Changes
This tracking of prescriptions is all part of the biggest
changes in healthcare since O’Neal started his career. It’s
maybe no surprise but technology has dramatically
changed the healthcare industry over the last 50 years.
“Major diagnostic changes from CTs and MRIs have
occurred. Major treatment modality changes have
occurred with many new chemotherapy, radiation, and
laser applications being developed. Research continues in
a tripod fashion that involves universities, government,
and private industry - especially Pharma,” said O’Neal.
With articial intelligence and machine learning continuing to advance, technological changes are not likely to
slow anytime soon. As long as O’Neal continues to have
his hand on the tiller, Georgia should be in good shape.
Baker Owens is a staff writer for James magazine and InsiderAdvantage.
SEPTEMBER/OCTOBER 2018
37

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