Though addiction to all types of drugs (including cocaine and methamphetamines) has steadily increased, the primary problem remains opioids. They came to the fore in the early 1990s in the form of prescription painkillers that were unscrupulously marketed to doctors as unlikely to cause addiction.
Naloxone is needed in greater quantities and closer to users, community groups say.
Addressing a public health crisis of this magnitude is a complex undertaking. Policymakers can work to prevent people from becoming addicted to opioids and to help people who are already misusing opioids to treat their addiction and minimize the risk of death or other harm. In general, there are four kinds of strategies:
The US urgently needs a smarter, multi-pronged strategy and cabinet-level leadership to tackle an escalating overdose epidemic which poses an unacceptable threat to national security and the economy, a bipartisan congressional commission has found.
The lessons from past drug crises and the evidence supporting a public health approach can guide policymakers as they seek an end to the current opioid crisis—without revamping the failed and costly War on Drugs.
To stem the opioid epidemic, an all-in, population health approach is required. This means working across sectors — health care and public health, economic development, housing, public safety and education — and ensuring equal access to effective treatment among diverse groups.
It’s likely that there are multiple causes of the problem. Doctors have played their part. “We started it,” author and surgeon Atul Gawande told Vox’s Sarah Kliff in an interview in September. Gawande acknowledged that in an effort to better treat pain in the mid-1990s, doctors overprescribed opioids without adequate attention to the consequences. Many experts at the time contended that pain had previously been undertreated in routine medical practice.
Pharmaceutical companies have also been implicated.
"Do No Harm: The Opioid Epidemic exposes the opioid lie we have been living in America for decades. This film and companion book can play a key role in educating communities about why opioid manufacturers should be held accountable for their calculated deception of health professionals and the general public. It's time for accountability. It's time for restitution. It's time to help our communities heal and recover."
America is failing to treat millions of people addicted to opioids. Here are the people trying to change that.
In response to the crisis in their communities and nationwide, AAMC-member institutions are actively working to advance medical research, education, and clinical care that addresses the opioid epidemic.
A new approach to fighting the opioid crisis as it quietly rages on.
Many more health care providers can help. But they need the tools and resources to do so..
Addressing this problem would cost money, too, but evidence suggests it would pay for itself. Much of the problematic use of opioids like Vicodin and OxyContin originates with a prescription to treat pain.
Doctors are not the only ones responsible for the opioid epidemic, but as Dr. Murthy makes clear, they’ll have to play a leading role in the fight against it.
Several immunizations show initial promise, but when they will be available remains murky.
Houry emphasized that “ EDs are a critical entry point for prevention of overdose , with opportunities to improve opioid prescribing, respond to overdoses with overdose education and naloxone distribution, engage in motivational interviewing of patients, initiate treatment for opioid use disorder, and improve surveillance efforts in collaboration with health departments. EDs and physicians who engage in these efforts can save patient lives and reduce health care costs.”
Opioid analgesic drugs, like morphine and oxycodone, are the classic double-edged swords. They are the very best drugs to stop severe pain but also the class of drugs most likely to kill the person taking them. In a recent journal article, I outlined how a combination of state-of-the-art molecular techniques, such as CRISPR gene editing and brain microinjection methods, could be used to blunt one edge of the sword and make opioid drugs safer.
Long after the Covid-19 pandemic winds down, opioid misuse will remain with us, costing lives, shattering families and plaguing communities. We can minimize the damage through proactive public policy, availability of affordable treatment and deployment of technologies.
The two sides of the epidemic are often described as if they’re in conflict: One side pushes for more action on cracking down on the supply of opioid painkillers, while the other insists that the real solution is to massively expand addiction treatment. The truth is that policymakers need to look at both, because each represents a unique population with different needs.
Addiction isn’t an illness like any other. Patients need not just the right medicines but therapy, support and, in some cases, tough supervision.
Effective treatments exist. But as treatment for over-dosing is increasingly available, treatment for addiction is still not accessible to many of those who need it. Access to effective treatments for opioid addiction is the missing piece in America’s unsteady fight against the opioid epidemic.
This award-winning series of stories reported in late 2018 explores how Switzerland, France and other European countries implemented drug policies and programs that have diminished their rates of opioid overdose and related infections.
Calling their curriculum deficient, students at Harvard Medical School are teaching themselves how to treat opioid addiction — joining the ranks of critics who say medical schools across the country aren’t doing enough to prepare doctors for a deadly crisis.
For people who do want treatment, however, the good news is that three FDA-approved medications exist to treat opioid addiction. Together, the three are often termed “medication-assisted treatment,” or MAT.
Could medical marijuana help solve America’s opioid crisis? The state of New York is convinced that it can.
We published a new study last month showing that highly marginalized patients on “opioid agonist therapy,” with the drugs methadone or suboxone, were more likely remain on their treatment six months later if they were using cannabis on a daily basis.
Physicians and other health care professionals have reduced opioid prescribing in every state for 10 consecutive years. They have increased the use of state prescription drug monitoring programs (PDMPs) in every state for the past five years. Despite these efforts, drug-related mortality continues to rise.
How much to prescribe, and to whom, is a complicated medical question.
Safer supply, the practice of providing a medical prescription for pharmaceutical drugs of known quality, is one of those new interventions. In Ontario, safer supply programs are run mostly by community health centres that specialize in providing care to our most marginalized community members. These small pilot programs are a low-barrier first step alternative to the toxic drug supply.
A new study shows that fentanyl test strips nudge drug users to take extra precautions.
“This isn’t just a story about rogue prescribers and pill mills,” says Caleb Alexander, co-Director of the Center for Drug Safety and Effectiveness at the Johns Hopkins School of Public Health. “A much broader swath of the medical profession is responsible for the oversupply of opioids in clinical practice.”
In May 2014, a diverse group of experts — including clinicians, researchers, government officials, injury prevention
professionals, law enforcement leaders, pharmaceutical manufacturers and distributers, lawyers, health insurers and patient
representatives — gathered at the Johns Hopkins Bloomberg School of Public Health. The group gathered to review what is
known about prescription opioid misuse, abuse, addiction and overdose; to identify strategies for reversing the alarming trends
in injuries and deaths from these drugs; and to make recommendations for action.
Politicians and the media are ignoring the one solution that could make a difference: more and better treatment.
Medications like buprenorphine help save lives, and we need to prescribe them, now. But we also can’t lose sight of the larger solution, which must be more than just 15 minutes and a pill.
There is a continued need by all multi-stakeholder organizations to recognize the scope and complexity of this problem to find equitable, accessible solutions and implement broad policy action for broad populations.
Few primary care doctors are willing to do what Nicole Gastala has: endure the challenges of prescribing buprenorphine, a medication for opioid addiction.
The study suggests a comprehensive approach is needed — one that goes way further than what America has done so far.
We, as clinicians, are uniquely positioned to turn the tide on the opioid epidemic - U.S. Surgeon General Vivek Murthy.
The Commission on Combating Synthetic Opioid Trafficking, established under Section 7221 of the National Defense Authorization Act for Fiscal Year 2020, was charged with examining aspects of the synthetic opioid threat to the United States—specifically, with developing a consensus on a strategic approach to combating the illegal flow of synthetic opioids into the United States.
CDC raises awareness about the risks of opioid misuse and abuse empowering the people to make safe choices. CDC created the Rx Awareness campaign to educate everyone about the dangers and risks of prescription opioids.