Surgeon General Murthy's exit creates uncertainty over opioid addiction fight

In a Facebook post written after being fired from his post as U.S. surgeon general, Dr. Vivek Murthy pointed to his work addressing addiction as a top accomplishment.

"I am exceedingly proud of what our team and our officers have done to bring help and hope to people all across America," Murthy said when asked why he didn't resign instead of being fired by President Donald Trump two years into a four-year post.

After being appointed by President Barack Obama, Murthy highlighted the opioid epidemic as one of the Obama administration's top priorities. He urged physicians to change how they prescribe pain medication and worked to diminish the stigma associated with addiction. In a landmark report in November, he called addiction one of the biggest public health problems of the past 50 years.

An HHS spokeswoman said Murthy was asked to resign after "assisting in a smooth transition" under Trump.

Rear Adm. Sylvia Trent-Adams, a 24-year veteran of the U.S. Public Health Service Commissioned Corps and former chief nurse officer in the corps, will fill Murthy's role on an interim basis. Surgeon general is a confirmed post and requires full Senate approval.

The Trump administration's decision has some opioid addiction experts concerned that strides made to tackle the epidemic will be stalled or squashed.

Andrew Kolodny, co-director of opioid policy research at Brandeis University, thinks the move is a step backward.

Kolodny said he questions the Trump administration's goals for combating the crisis with Dr. Scott Gottlieb's nomination to lead the Food and Drug Administration, as well as the rumored pick to head the Office of National Control Drug Policy, U.S. Rep. Tom Marino (R-Pa.). Both have strong pharmaceutical industry ties that some say could help collaborative efforts to curb practices that aid addiction. "I am worried that we've just finally started to see the real driver of the problem—overprescribing," Kolodny said. "If we lose the focus on that, I'm worried the epidemic will never come to an end."

Dr. Krisda Chaiyachati, a physician and researcher at the University of Pennsylvania who has studied opioid use, believes the Trump administration won't give up on the issue. But, he added, "We haven't received clarity on the strategy moving forward" to combat the epidemic.

There are also concerns over the president's proposed 20% cuts to the National Institute of Health's $30 billion budget. A $500 million appropriation to help states expand opioid prevention efforts is not new funding, but money previously authorized under the 21st Century Cures Act.

Public health