The Untold Story of the Opioid Crisis in American Healthcare

By Michael Vasquez

"I have personally witnessed the devastating impact of America's opioid epidemic. For over three decades, I worked in law enforcement and government, often in roles closely associated with the drug crisis. I began as a federal drug prosecutor in Los Angeles and served as the Director of the Office of Counternarcotics Enforcement at the

• Language: English
• Publisher: Michael Vasquez
• Release date: Mar 13, 2024
• ISBN: 9798869249487

Book preview

The Untold Story of the Opioid Crisis in American Healthcare

New Era of Prevention Through AI

As the U.S. Secretary of Health and Human Services, I saw for myself what a tragedy opioid addiction can be. I am hopeful about the opportunities that AI offers and enthused that Mike is paving the way.

- Gov. Tommy Thompson

Michael Vasquez

Foreword by Hon. James Carroll, Former Whitehouse Drug Czar

Copyright © 2024

All Rights Reserved

Dedication

To my wife, Rose Marie, this book is dedicated to you. You are my partner, my best friend, and the love of my life. Your steady support, unwavering strength, and solid belief in me have been the foundation of our beautiful relationship. This book is a tribute to the love we have cultivated, the adventures we have embarked upon, and the memories we have created together. You are mine forever, and I dedicate this book to you with all my love.

To our boys, Mike Jr, Nicholas, and Anthony, you are living proof of our commitment to each other and to our family. Watching you grow, learn, and flourish has been the greatest privilege of my life. Through this book, I hope to inspire you to chase your dreams, embrace your passions, and always remember the values we have instilled in you.

To my grandchildren, you are the shining stars that illuminate our family’s legacy. Your innocence, curiosity, and boundless potential fill me with hope for the future. Through this book, I hope to pass on the wisdom, stories, and experiences that have shaped me so that you may carry them; and inspire you to create your own remarkable journey.

May the words within these pages serve as a tribute to the love that binds us, the values that guide us, and the memories that connect us across generations.

With my love,

Mike

Acknowledgment

I would like to take a moment to express my deepest gratitude to my family, co-workers over the years, and publisher for their unwavering support and contributions to the creation of this book.

To my co-workers over the years, investors, and board members, thank you! Your encouragement and belief in my abilities have been instrumental in keeping me motivated and focused.

To my publisher and editors, including Megan, thank you for helping me make this book a reality. Your guidance, expertise, and belief in this project have been invaluable. I am grateful for the opportunity to work with a team that came to share my vision and passion for this work.

I am truly fortunate to have such an incredible network of support, and I am humbled by the love and encouragement I have received throughout this process. Without each and every one of you, this book would not have been possible.

Some believe the opioid crisis can be prevented by expanding treatment and limiting access…when in fact, prevention reduces the need for treatment and allows access.

- Michael Vasquez

About the Author

Since 1986, Mr. Vasquez has been the founder of industry-transforming companies in the United States. He started his career as a software developer, working at AT&T. In 1987, Mr. Vasquez founded a computer consulting firm, where he wrote the software that automated Ladies Home Journal Magazine, which was previously being produced manually using typewriters.

The consulting firm was later merged with PACE Health Management, which developed the first electronic medical record (EMR) system to go public on NASDAQ using expert systems and artificial intelligence neural networks. This helped develop clinical pathways supporting clinicians who took patients from admission to discharge. The company was later sold to 3M Healthcare.

In 1998, Mr. Vasquez founded CareMedic Systems – the first real-time processing system for hospital Medicare Part A claims. In 2000, the Mayo Clinic Foundation purchased 5% of the company, and by 2004, CareMedic software was serving 1,500+ hospitals across America.

The company was sold in 2005 to United Healthcare Optum and continues to flourish today as a product.

In 2007, Mr. Vasquez and his wife founded St. Gregory Retreat Centers for people suffering from substance abuse. St. Gregory developed a proprietary cognitive behavioral therapy (CBT) program and served 10,000+ addicted patients, 25% of whom were addicted to heroin or prescription painkillers. Mr. Vasquez worked with research physicians to understand, develop, and deliver a solution to reduce or eliminate cravings for opioids. Over 2,000 patients were accommodated using 14,000 treatments with almost no adverse effects, resulting in 84% of patients staying alive, sober, and working after 48 months. The company was sold in September 2018.

In 2012, after interviewing hundreds of opiate and heroin-addicted patients, Vasquez saw a constant theme where patients had become dependent due to prescriptions provided by their doctor. In an effort to reduce opioid prescribing, Vasquez founded Harbor View Medical, which provided orthopedic stem cell procedures developed by Regenexx© as a non-invasive alternative for people who were facing orthopedic surgery and were given potentially long-term opioid prescriptions. Harbor View Medical was merged with Regenexx© in 2017.

In 2019, Opioid Clinical Management (OPCM), Inc. was founded in response to the dramatic opioid epidemic and the national need for a solution. OPCM has developed proprietary AI algorithms (patent pending) that 1,700 self-insured employers use today.

In 2000, Mr. Vasquez was named Ernst & Young Entrepreneur of the Year and was inducted into the Entrepreneur of the Year Hall of Fame.[1]

Mr. Vasquez attended the U.S. Air Force Academy and Drake University, and he received his Executive Health Management Certificate from the Harvard School of Public Health.

Foreword

In my role as the Director of the White House Office of National Drug Control Policy (ONDCP), I operated with the motto Be relentless. My commitment to the relentless pursuit of better drug control policies made a difference.

During my tenure as the White House Drug Czar, overdose deaths decreased — something that had not happened for three decades. Also, law enforcement personnel along the borders seized a record amount of illegal drugs.

I am here to tell you, however, that seizing drugs at the borders is not enough. Funneling more and more money into treatment programs is not enough either. These actions are certainly critical, but they alone can’t make the difference that effective prevention can.

Through long-term prevention strategies, we will reduce the number of people desiring the drugs coming through our borders, and we will lower the number of people becoming addicted or worse.

Technology offers us a promising solution. Mike, in this book, shows how to harness the power of analyzing healthcare data to make a change.

This might sound like wishful thinking, but Mike Vasquez knows how to make it happen. In this book, he shares with you the key to making it a reality.

His impressive background in both healthcare innovation and drug treatment gives him a perspective that you won’t find anywhere else. Learn from his experiences and consider the difference that his ideas could make in your company, community, and across the nation.

Hon. James Carroll

Former Director of National Drug Control Policy (ONDCP),

White House Drug Czar.

Contents

Dedication

Acknowledgment

About the Author

Foreword

Chapter 1: How My Personal Experiences Began to Shape My Business Endeavors

Chapter 2: Getting Started with Treatment Centers

Chapter 3: From Treatment Centers to Shocking Discovery

Chapter 4: History of the Opioid Crisis

Chapter 5: The History of Treatment Centers

Chapter 6: Response Strategies (Treatment) v. Prevention Strategies

Chapter 7: The Brain Chemistry of Addiction — How and Why It Happens

Chapter 8: Difference Between Withdrawal and Addiction

Chapter 9: Risk Factors of Progressing from Withdrawal to Addiction

Chapter 10: The Cost of Not Recognizing the Progression to Addiction

Chapter 11: Relying on Addiction Indicators in Pharmacy and Insurance Data

Chapter 12: The First Indicator: Increased Health Plan Costs – Side Effects of Withdrawal

Chapter 13: The Role of Physicians- The Hidden Problem and Its Solution

Chapter 14: Technology Invented to Identify Withdrawal Indicators

Chapter 15: How to Find the Problem- Retrospective Review

Chapter 16: Now How Do You Get the Doctors to Change?

Chapter 17: The Opioid Settlement and How It’s Being Used

Chapter 18: Other Solutions on the Market: A Paradigm Shift in Approach

Chapter 19: How Can the Opioid Crisis in America Be Solved?

Chapter 1: How My Personal Experiences Began to Shape My Business Endeavors

My mother was a young girl when she came to America, leaving behind the green fields of Carrick-on-Suir, Ireland. She got an unexpected call from her aunt, Sister Mary Zita Brennan, a Sister of Mercy, who asked her to come to America. To put it straightforwardly, my mother had no other plans for life, so she packed her bags and went to America. Sister Zita, as she was known to everyone, wanted my mother to study nursing. That’s what my mother did.

Arriving in Des Moines, Iowa, she was in awe of the bustling streets and big-city feel. Quickly setting into her new life, she started attending nursing school at Mercy Hospital and Drake University.

It was at Drake University where my mother met my father, a handsome man from Mexico who, after serving in Korea, came back to Des Moines to work on the Rock Island Railroad. Falling in love quickly, they married and started a family. Nevertheless, my mother didn’t know about the misfortune that awaited her.

My mother suffered a terrible fall down a flight of stairs at work and suffered a back injury. The year 1960 was a difficult time for me. The year my mother suffered a back injury, I saw her in constant pain. Her aching and spasms worsen with each passing day. Whenever she made certain movements, the pain made her bewail. She couldn’t sit or walk properly because of the injury. Her backbone got stiff after the injury, and she had to have surgery and stay in the hospital for almost six months.

The doctors gave her morphine to ease the pain, but little did they know that the drug was addictive. In 1960, doctors did not believe opioids were addictive. Morphine is an opioid analgesic. It is commonly used in pain management in various clinical situations, but it is a highly addictive prescription. Being made from opium, it is a strong opiate drug with many side effects. Its overdose often results in nausea, dry mouth, lightheadedness, CNS depression, dizziness, and sedation.

Despite this widespread belief that hospital-administered morphine could not lead to addiction, my mother developed Morphine dependence by the time she left the hospital. Because experts didn’t think that a hospital stay would leave patients with a debilitating addiction, no one was looking for the signs of opioid dependence. They weren’t managing her access to medication or paying attention to the subtle clues of opioid addiction.

The next several years were a blur of pain and confusion as my mother’s condition deteriorated. Imagine feeling like you’re fighting a constant battle every single day just to feel normal. That’s the reality that my mother faced as she struggled with addiction to morphine. As a nurse, she had easy access to morphine. Deep down, she knew that she was using it to self-medicate and escape the grips of withdrawal symptoms.

It’s hard to imagine what it must have been like for her to be a nurse and yet also a slave to the very substance that she was supposed to be administering to her patients. And yet, despite this inner turmoil, she managed to maintain a facade of normalcy on the outside. To the world, she appeared to be her regular self - a hard-working nurse who was dedicated to helping others. The drug also impacted her mood, and her mood swings were lethal. As a child, it was hard for me to understand why she suddenly seemed happy and what turned her down readily. Her addiction left her drained and depressed.

She struggled. The battle raged on inside of her - a battle between her addiction and her desire to break free from its hold. The moments in which she didn’t have the drugs became moments of agony for her. Her withdrawal symptoms began to kick in. Her body twinged, her mind raced, and her spirit squeezed under the burden of her addiction.

Consequently, she continued to rely on the steady supply of morphine that she had access to. It allowed her to feel normal. I grew up watching my mother in dysphoria. Restless and distressed, she tried to give me the attention I needed, but she couldn’t help herself. Whenever I saw her, I could discern helplessness in her person. Her visage, which was once joyful and cheery, grew grim and sad. My mother was withering in front of my eyes because of that drug. I did not know the cause, and I was unable to do anything.

One day, when I was 14 years old, I came home from school and found her unconscious on the kitchen floor with a needle in her arm.

I didn’t know what to do. Neither did my dad. Drug addiction wasn’t something that most people talked about in 1969; most families kept such matters as private as they could, so we didn’t know anyone who had walked this journey before us to whom we could turn for guidance. Of course, there was no internet, and we could not search for help and support either.

So we did what we knew to do in an emergency; we called an ambulance. The ambulance took her to the hospital. After being stabilized, she was admitted to the hospital for drug treatment. In those days, though, going to treatment just meant being put in the psych ward. Drug addiction was seen as a moral failing, a behavioral health issue, not a medical condition. This is how drug addiction impacted individual lives, families, and social relationships back then. A strain divided us. I know that the damage was irreparable. At an early age, I was deprived of the all-embracing, nourishing, and warm love that I needed. The lack of that warmth forced me to become self-reliant and driven.

It took two separate stays in hospital treatment facilities, but she did manage to break free from her opioid addiction.

I’m incredibly thankful that my mom was around to meet my future wife, Rose Marie, and see the birth of our three boys and enjoy them as youngsters. As hard as my mother’s experiences were for her — and as confusing as they could be for me as a young person — I appreciate the perspective that I gained along the way. Her struggles gave me a better understanding of what families caught in an addiction crisis go through. Those lessons would come back into play later in my life.

This and many agonizing experiences at a very young age provided me with reasons to find solutions. All the frailty that existed in my surroundings made me even stronger. What I have become today are the results of such traumatizing experiences and the consequent frustrations that came with them. My career and business pursuits are the product of those lifelong experiences. Over time, I developed various business ideas from the problems I faced. Analyzing the causes of problems, I searched for solutions through technology.

It is pertinent to share some of the ordeals and sad episodes that engendered motivation in me. Coming up against these challenges became a personal goal and professional objective. Using my skills and acumen as a budding computer entrepreneur, I vowed I would not let other people live the same fate.

I underwent major surgery in 1980 at the age of twenty-five. I was planning our wedding with my fiancée, Rose Marie;