The Government’s Response to the Opioid Crisis [History Of Opium: Part 17]
“The biggest misconception is that the U.S. is normal in how it handles prescription opioids.”
– Dr. Keith Humphreys, Psychiatry and Behavioral Sciences, Stanford University
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In 2016, over eleven million Americans misused prescription opioids, one million used heroin and over two million had an opioid use disorder due to prescription opiates or heroin. The growing black market is also a major driver of increased deaths due to illegal Fentanyl and Fentanyl analogues.
The opioid epidemic is socially, medically and economically overwhelming this country and its citizens. Not only does it affect people who are in the throes of addiction, it inflicts terrible (and oftentimes irreversible) emotional, physical and financial damage on families, friends, communities, social services and law enforcement, just to name a few. Needless to say, governmental intervention, cooperation and leadership is vital when it comes to making any headway against such a wide-ranging crisis. As with any issue that impacts millions of citizens, several agencies will have to commit time, resources and money in order to have any hope of solving it.
Some of the agencies that are currently working to get this crisis under control are: the Substance Abuse and Mental Health Services Administration (SAMHSA), the Centers for Disease Control (CDC), the National Institutes of Health (NIH) and the Food and Drug Administration (FDA).
Riding herd over these factions is the White House, where, in October of 2017, Donald Trump declared a ninety-day public health emergency and promised to roll out a “really tough, really big, really great” advertising program intended to spread awareness about the problem. His plan aims to galvanize the government to end the crisis. In March of this year, the CrisisNextDoor.gov website was launched to provide people with a forum to share their own opioid-related stories.
In October 2017, Dr. Francis Collins, Director of the NIH, appeared before the Senate Committee on Health, Education, Labor and Pensions to outline just how the agencies listed above (and many others) would work towards the goal of eradicating this scourge. The centerpiece of his testimony was focused on the five-point Opioid Strategy outlined by the Department of Health and Human Services in April of 2017. They are summarized here:
1. Access to Better Prevention, Treatment and Recovery Services. In 2017, the Department of Health and Human Services issued over $800 million in grants to support a variety of efforts in this area. For example: The Health Resources and Services Administration (HRSA) allocated over $4 million in grants to thirty-four rural health organizations to increase access to treatment and recovery services in these communities.
2. Compile and Report Better Data Pertaining to the Epidemic. This mandate supports and encourages the development of useful and timely data. For example: Last year, the CDC released the first Annual Surveillance Report of Drug-Related Risks and Outcomes – United States, which provides the latest statistics pertaining to opioid prescribing rates, substance use disorder nonfatal hospitalizations, emergency department visits and overdose deaths.
3. Develop More Effective Pain Management Strategies. This is an effort to promote healthy, evidence-based approaches to deal with pain management. For example: The NIH HEAL (Helping to End Addiction Long-Term) Initiative is dedicated to discovering non-addictive treatments for pain management in an effort to curb opioid misuse.
4. Improve Availability of Overdose-Reversing Drugs. In April of this year, the Surgeon General released Advisory on Naloxone and Opioid Overdose, which promotes the importance of access to this lifesaving drug. For example: SAMHSA awarded 44 million to the First Responders – Comprehensive Addiction and Recovery Act, which provides training and overdose reversing medicine to first responders.
5. Improve Research about Pain and Addiction. This effort spearheads the development of cutting-edge research on pain and addiction. For example: In September of 2017, several federal agencies, including The NIH, DOD and VA announced a partnership that is tasked with developing non-drug treatments to address the pain management needs of veterans and members of the military.
In March, 2018, Trump signed a $1.3 trillion budget, which included a $4.2 billion allocation to fight the opioid crisis this year. While this seems like a large line item, it must be noted that opioid abuse and its fallout costs this country over $500 billion annually. The President’s Commission on Drug Addiction and the Opioid Crisis was also established to: cut down on bureaucracy, increase awareness about drug misuse, reduce inappropriate prescribing, improve drug monitoring programs, strengthen law enforcement efforts, reduce the amount of illegal drugs entering the country, expand access to treatment and recovery services as well as overdose reversing drugs and development of opioid alternatives to address pain.
On July 12, 2018, Attorney General Jeff Sessions announced the formation of Operation Synthetic Opioid Surge. This initiative intends to reduce the drug supply in areas that have been most impacted by the crisis. Part of the goal is to “identify wholesale distribution networks and international domestic suppliers.”
The current administration has held summits, released initiatives and convened commissions designed to fight this epic battle, and those on the front lines of these efforts should be applauded. Critics, however, argue that substantial progress is yet to be made in this war against opioids.