Listen to Vikram Krishnasamy discuss his work:
When federal law enforcement authorities arrested 60 doctors, pharmacists and other medical professionals in six states in 2019 for illegally prescribing and distributing opioids, a Centers for Disease Control and Prevention physician worked from a command center helping state and local authorities deal with the health care fallout affecting thousands of patients.
This first-ever federal coordination between law enforcement and public health officials was led by 35-year-old Dr. Vikram Krishnasamy of the CDC, who focused on ensuring that patients dependent on pain medications and left without medical care could be directed to legitimate professionals and addiction treatment providers.
“Vikram served as the gateway between law enforcement and the state public health officials,” said Gary Cantrell, the deputy inspector general for investigations at the Department of Health and Human Services. “We had hotline numbers established, mobile health units deployed and public health officials on site at the clinics where patients were arriving. None of this would have been possible if it hadn’t been for Vikram’s efforts.”
Krishnasamy’s role in this major law enforcement effort is just one aspect of his work helping state and local officials across the country deal with opioid overdoses, which have resulted in an average of 128 deaths a day in the U.S., and some 400,000 deaths since 1999.
Krishnasamy also has been responsible for preparing detailed materials and a comprehensive training program for CDC rapid response teams to support states during times of crisis.
“There are hundreds of CDC employees and U.S. Public Health Service officers from other agencies who have now been trained in both basic knowledge about the opioid epidemic and skill sets needed to support local state health departments because of Vikram’s work,” said Dr. Anne Schuchat, the CDC’s principal deputy director.
“This kind of knowledgeable, trained workforce is important not only when there’s a closure of the pill mill or a spike in drug overdoses, but it’s also important in other emergency contexts such as a hurricane or earthquake that temporarily separates individuals from their prescription drugs,” Schuchat said.
When Schuchat tapped Krishnasamy to take on the opioid project, he had just finished a fellowship with the CDC’s Epidemic Intelligence Service, a disease detective group that goes through a two-year intense applied epidemiology training experience. He had worked mostly in foodborne disease and had no experience regarding opioids but very quickly learned and distilled an extensive amount of scientific information. From there, Krishnasamy created a comprehensive, easily digestible 16-hour online training course to help responders increase their understanding of the opioid crisis.
Since its launch in 2019, more than 1,000 CDC staff and Public Health Service officers have completed the online training. Recently, several of the trained staff, along with Krishnasamy, have contributed to CDC’s e-cigarette associated lung injury activities and the COVID-19 pandemic response.
Krishnasamy’s most lauded achievement—bringing together public health officials and law enforcement on the opioid crisis —was as much grounded in interpersonal and communication skills as it was in medicine.
“Traditionally, law enforcement authorities have been understandably cautious in sharing information about planned actions against outlier opioid prescribers,” said Dr. Deborah Dowell, chief medical officer at the National Center for Injury Prevention and Control, and Krishnasamy’s supervisor.
“However, reluctance to share information has meant that health officials have been unable to prepare for impacts on patients following abrupt removal of pain management providers,” Dowell said. “Vikram addressed this gap by establishing a trusted contacts network across law enforcement and public health, leading to significant advances in communication.”
Because of the groundwork laid by Krishnasamy, the 2019 opioid prescriber crackdown marked the first time that local public health officials received a heads-up—in this case several weeks—about a major action law enforcement was taking.
“We’ve heard from multiple health departments saying that made all the difference in ensuring they provided adequate follow up and services for the patients that were affected by these actions,” Dowell said.
Not only did Krishnasamy succeed, he did so under a tight timeline.
“Vikram has an extraordinary ability to get things done, accomplishing more in a single day than most people are capable of completing in a week or more,” Dowell said.
Krishnasamy said he was drawn to the CDC because he is dedicated to “improving public health at a large scale.”
“It’s rare and a privilege to be able to be on the frontlines of public health,” Krishnasamy said. “It is very meaningful, and it can have a big impact.”
“Vikram is a superstar,” Schuchat said. “He is a humble leader who is always about the mission. He cares about doing the right thing for the American public and using his medical and public health skills for the betterment of the community.”