America’s Opioid Epidemic
Here’s a startling statistic: someone dies of a drug overdose every 12 minutes in the United States.
An addiction to a prescription drug such as like Vicodin, OxyContin, or Percocet can lead to heroin abuse or the possession of a controlled substance—and the increasing number of deaths and injuries this causes is alarming. So much so that Republicans and Democrats on the House Energy and Commerce Committee are working to combat the abuse prescription drug and opioids.
“Let me state clearly so as to leave no room for doubt: Our current strategies are failing and I am not going to stop until we start moving in the direction of success defined not just as getting individuals off of street drugs and onto a government-approved opioid, but getting them to the point of drug free living and to also identify appropriate treatment options for those with underlying mental illness,” said Rep. Tim Murphy (R-PA).
The Centers for Disease Control and Prevention (CDC) reported that nationally, nearly 260 million opioid prescriptions were written in 2012, and Americans consume 80% of the world’s prescription opioids, despite constituting just 4.6% of its population. Those number show that our country is in the midst of an opioid epidemic.
The current federal policies on opioid addiction stemming from the possession of controlled substances like heroin frequently stress a law enforcement approach without a concern for public health. However, it’s apparent that this is a public health crisis, and as Representative Fred Upton of Michigan’s 6th District says, our strategy must reflect the complex dynamic between public health and criminal activity.
On the bright side, opioid addiction is a chronic disease of the brain that responds to treatment. However, only 10% of the 23 million people suffering from alcohol and drug addiction receive any form of treatment—and of those who do get treatment, only 10-20% receive evidence-based treatments which has been shown to be effective in repeated studies. Along with this, treatment for opioid addiction needs to be more integrated with primary health care to ensure the best health outcomes, Upton says.
The committee also found that programs and services provided by addiction treatment centers frequently use acute individual treatment models in response to the chronic health problem of opioid addiction, where those with opioid addiction frequently may need treatment for longer periods of time. Also, behavioral counseling, which is recommended for use in conjunction with medications, is not always available.
Upton says that we need to develop and circulate practice guidelines for the use of medications—including opioids—in the treatment of chronic pain. This will help change doctor prescribing behavior with information and tangible incentives to prescribe more judiciously, but not sacrifice treating pain and addiction. Opioid-addicted individuals must also be able to choose from a full range of proven pharmacological treatments, including behavioral and psychosocial therapies.
The paradigm of substance use treatment must be shifted to a long-term view, Upton advocates, like other chronic diseases. Greater accountability is critical for treatment programs to include increased public reporting of continued illicit drug use, success and retention rates, better program controls, and a renewed focus on reducing the incidence of drug diversion.
The Energy and Commerce Committee is reviewing several bipartisan bills crafted around these solutions, but this is just beginning. Republicans and Democrats have a responsibility to help those individuals in our communities who are suffering with addiction.
Our nation’s current approach of dealing with the Opioid Epidemic with arrests and incarceration is not the solution. No one is going to be cured by sitting in prison for heroin possession or possession of a controlled substance.
This is a public health crisis, and it needs a public health solution.
Photo courtesy of Wikipedia by David Richfield