UPDATE: Medicaid official's own family tragedy drove him to tackle the opioid crisis head-on

01/11/18 10:03 AM EST

By Emma Court

Andrey Ostrovsky found out two years after his uncle's death that it was an overdose -- and he says it all comes down to stigmatization

Andrey Ostrovsky's uncle had always been a charismatic, fun, even brilliant person, and his death left behind a slew of unanswered questions.

Why couldn't he hold on to a job? Why wouldn't his ex-wife speak to him? Why hadn't he seen his daughter since she was a baby?

After the uncle died, it was two years before Ostrovsky and his family learned the truth: He had been an addict for about a decade, and he had eventually overdosed on opioids and cocaine.

Ostrovsky is a doctor, and as the chief medical officer of the Center for Medicaid and CHIP Services, worked to develop the center's strategy for the opioid epidemic, which has become the U.S.'s deadliest drug crisis (http://www.marketwatch.com/story/americas-opioid-epidemic-is-everywhere-but-its-especially-bad-in-these-5-states-2016-02-24).

When he tried to make sense of his uncle's death, and why nobody seemed to have known about his addiction, it all appeared to come down to stigma. And as someone who's coped with his own abuse issues -- with alcohol, specifically -- in the past, Ostrovsky knows just how hard it is to talk about addiction.

See: America's opioid epidemic is everywhere, but it's especially bad in these 5 states (http://www.marketwatch.com/story/americas-opioid-epidemic-is-everywhere-but-its-especially-bad-in-these-5-states-2016-02-24)

Now he's taking a more head-on approach to the opioid crisis, as the chief executive and president of Concerted Care Group, an addiction treatment center in Baltimore that takes largely Medicaid patients and has national ambitions. He'll also be a co-founder and partner in a new, parallel fund that invests in technology to help with efforts to treat addiction.

Ostrovsky's hope is to make it possible for everyone to have equal access to addiction treatment, regardless of economic status.

When you have a physical symptom, like acid reflux, "we can talk about that at a cocktail party + or maybe not at a cocktail party," Ostrovsky says, laughing. "That was not the case for my uncle and certainly not in our culture. And that sucks, because he's dead."

Related: Opioids are ravaging the U.S., but they're still the best pain drug we've got (http://www.marketwatch.com/story/opioids-are-still-the-best-pain-drug-weve-got-2017-05-26)

Ostrovsky and his family moved to the U.S. from Ukraine in the late 1980s, and he grew up, on Medicaid, in West Baltimore. After medical school -- he trained as a pediatrician, and still attends one night a week -- Ostrovsky wound up working in public policy and technology.

He started at the Centers for Medicare and Medicaid Services in September 2016, mere months before the presidential election had an outcome that he, and many others, hadn't expected.

Though he wasn't thrilled with the new administration, calling his new bosses "just as bad as Trump and just a little more competent," and made that view known, Ostrovsky was set on sticking it out. That was, until he found out more about his uncle's death.

Before he met with a friend of his uncle's at the end of October, Ostrovsky and his family suspected suicide, but they weren't sure. Later, he learned that though his uncle had been an addict for many years, the situation worsened in the months before his death. He began to experiment with more drugs, lost a job that family members had helped set him up with, and began to spiral.

See: The FDA says controversial supplement kratom could make the opioid crisis worse (http://www.marketwatch.com/story/the-fda-is-cracking-down-on-controversial-supplement-kratom-2017-11-14)

Ostrovsky attributes some of the mystery around his uncle's situation to his family's cultural background, saying, "This is not a culture of open discussion about mental health. Mental health is incredibly stigmatized."

But stigma is everywhere, he says.

"My goal in even sharing this stuff is I want other families to know -- talk about this," he says. "We can't hide it. We need to make it public. And we need to celebrate the folks who are trying to recover from addiction. We have to make the dialogue around addiction open and treat it like any other chronic disease."

Read more: A new estimate sets the opioid crisis' cost at six times higher than before (http://www.marketwatch.com/story/how-much-is-a-human-life-worth-calculating-opioid-crisis-cost-confronts-an-existential-question-2017-11-21)

Ostrovsky wishes that his uncle's life had taken a different turn, like that of his friend -- the same friend who shared the full story of the uncle's death with Ostrovsky -- who went and got treatment and is now an addiction counselor.

But Ostrovsky also knows how difficult it is, and is sympathetic to the way addicts are treated by society. Many still believe, wrongly, that addiction is a moral failure rather than a medical diagnosis, and good treatment is still too hard to come by.

"I ran a company and have had some good successes in life, but I've had my issues -- I have my issues. Everyone has their issues. I'm lucky that I had a supportive family that helped me get treatment," he says. "Other people are not so lucky."

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-Emma Court; 415-439-6400; AskNewswires@dowjones.com


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01-11-18 1003ET

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