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Putting the Focus on Prevention

A leading medical toxicologist and Chicago Medical School Distinguished Alumnus pushes for prevention as the first line of attack against the vaping and opioid epidemics.

Medical toxicologist Jerrold Leikin, MD ’80, has spent his career in the treatment and prevention of poisoning, which encompasses substance misuse disorders that, according to the National Institute on Drug Abuse, costs the nation $740 billion a year in related health care, crime and lost productivity.

Dr. Leikin has witnessed the long-simmering problem of opiate misuse morph over the past two decades into a crisis of synthetic opioid addiction. He has worried and warned about the potential health risks of e-cigarette use, or vaping, which became apparent this spring in a multistate outbreak of lung injuries among users. He has seen five such cases and is working with the Centers for Disease Control and Prevention and the Illinois Department of Public Health to determine the causes of the outbreak and effective treatment.

As of early October 2019, vaping-related injuries had caused at least 18 deaths. A majority of the products implicated in the outbreak contained tetrahydrocannabinol (THC), a psychoactive component of the marijuana plant, which appears to have been tainted.

We’re experiencing an enormous crisis in health care and it’s mainly because of the lack of psychiatric services.
Jerrold Leikin, MD '80

“It’s so frustrating but so predictable to see vaping pulmonary failure, for which there is no really good medical therapy,” said Dr. Leikin, who is director of medical toxicology at NorthShore University HealthSystem–OMEGA located at Evanston, Highland Park, Skokie and Glenbrook hospitals in Illinois. “These are healthy young kids, for the most part, using a product they thought was innocuous and that they were pretty much told was innocuous. I believe that’s part of liberalizing cannabis use, which I have been against from day one.”

Legalization of recreational cannabis goes into effect in Illinois on Jan. 1. 

“I think it is reckless, especially in the middle of an opioid epidemic,” Dr. Leikin said. “Haven’t we learned that you do not promote psychogenic drugs with unlimited doses to vulnerable populations? That’s what happened with opioids and that’s what’s happening with cannabis.”

In a devastating trend tracked by the federal government since 1999, drug overdoses have become the leading cause of death for people under age 55 in the United States, where overdose kills 130 people each day. Dr. Leikin cites the high rate of psychiatric comorbidities among patients with substance use disorders. Mental health services including psychotherapeutic interventions are crucial, but often hard to come by, for improving outcomes. 

“We’re experiencing an enormous crisis in health care and it’s mainly because of the lack of psychiatric services,” said Dr. Leikin. “It’s very difficult for emergency department staff to get patients to appropriate psychiatric care in a timely manner. There are fewer and fewer psychiatric beds in the state at a time when we need more. Society has got to place a premium on mental health services.”

Dr. Leikin, who is a founding member of the Toxikon Consortium based at John H. Stroger, Jr. Hospital of Cook County in Chicago, spoke at RFU last spring during “Exploring the Opioid Crisis,” a Chicago Medical School Clinical Sciences and Humanities Grand Rounds. 

“Addiction medicine is too fragmented,” he said. “It’s got to be more than MAT (medication-assisted treatment). There has to be a strong psychosocial component. We have to do a better job of offering psychiatric and psychological treatment. Addiction is a complex disease with many complex tributaries. A 40-year-old who breaks a leg and becomes addicted to narcotics is different from a 15-year-old who is experimenting with narcotics.”

Dr. Leikin is co-author of the influential “Best Practices for the Treatment of Patients with Mental and Substance Use Illnesses in the Emergency Department,” the work of an Illinois Hospital Association subcommittee, which was published in the journal Disease-a-Month, where Dr. Leikin has been senior editor for more than a decade. He continues to urge greater emphasis on prevention through increased drug testing, education, counseling and referrals for adolescents in school; strong investments in mental health services, treatment centers and poison control centers; and more research, including long-term studies on the effective use of MAT.

“We have to put more focus on preventing addiction, which has to be done at the middle school and high school levels,” said Dr. Leikin, who calls for a medical approach to drug misuse in adolescence, with a focus on health and wellness and intervention services, including screening and treatment.

A member of the Illinois State Board of Health and a participant in the North Shore Coalition for Drug-Free Communities, Dr. Leikin is certified in internal medicine, emergency medicine, medical toxicology and addiction medicine. He is a prolific author and speaker and has given more than 250 interviews to national and international media on poisoning and related health issues since 1984, the year he completed dual residencies in internal and emergency medicine and went to work as physician-in-charge of medicine/emergency medicine at the University of Illinois at Chicago. 

Posted November 27
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