usatoday.com: With 175 Americans dying a day, what are the solutions to the opioid epidemic?

1/29/2018

Jerry Mitchell, The (Jackson, Miss.) Clarion-Ledger

 

More than 175 Americans will die today of drug overdoses.

The daily death toll from drug overdoses is like a 737 crashing and killing all the passengers on board. If plane crashes like that happened a few days in a row, “we’d shut the skies down until we figured out the problem,” said former Mississippi Attorney General Mike Moore.

But it’s not a plane crash. It is America’s opioid epidemic, one that unchecked could claim 1 million lives by 2020.

“This really is a national emergency,” said Moore, who championed the litigation against tobacco companies and is now involved in litigation against opioid makers. “The problem is we’re not acting like it is.”

Suggested solutions run the gamut, from gathering key players to utilizing the army of recovering drug addicts to fight the problem.

 

New Jersey Gov. Chris Christie, who headed the president’s opioid commission, remembers marches in every major U.S. city during the AIDS crisis, with people asking the government to find a way to stem the deaths.

Although more people have been hurt in the opioid epidemic, the marches haven’t come because of the stigma surrounding these overdose deaths, he recently told the House Oversight and Government Reform Committee.

Proof that stigma has been overcome will take place when people are willing to show their faces, march and demand that the government do something, he said. “The stigma is causing death, every day, almost as much as the drug itself.”

President Donald Trump’s opioid commission asked him to declare a national emergency.

 

Trump stopped short of that, announcing a public health emergency, but vowed to battle “the worst drug crisis in American history. … We can be the generation that ends the opioid epidemic.”

Dr. Andrew Kolodny, co-director of the Opioid Policy Research Collaborative at Brandeis University, said Trump was correct in calling the matter an emergency, but found the lack of action baffling. “If you call something an emergency,” he said, “urgent action should immediately follow,” he said.

To solve the opioid epidemic, “we have to prevent more people from becoming addicted,” he said. “This requires much more cautious prescribing.”

For the millions already addicted, “we have to ensure that effective outpatient treatment is easier to access than prescription opioids, heroin or fentanyl,” he said.

In 2016, more than 11 million Americans abused prescription opioids, nearly 1 million used heroin, and 2.1 million had an opioid use disorder from prescription opioids or heroin.

Although millions of Americans are addicted to opioids, only 1 in 10 actually gets treatment.

Moore said if all the opioid addicts could be treated, the cost would run somewhere between $50 billion and $100 billion — a bill he believes that drugmakers should pay.

Addiction specialist Dr. Drew Pinsky said there is a whole army willing to help these addicts free of charge: those involved in 12-step programs across the U.S.

 

Moore said the country also needs to make sure that emergency responders have enough of the drug naloxone, which rapidly reverses opioid overdoses.

“Finally,” he said, “there must be a change in the mindset of the American people, just as there had to be with tobacco.”

He believes the epidemic can be ended.

“It’s time for all the players involved on all sides to sit down in a room, develop a resolution and don’t leave the room till it’s done,” he said. “Too many lives are being lost.”

Purdue officials said the “opioid crisis is a complex public health problem that demands a diverse group of stakeholders to address it.”

FDA Commissioner Dr. Scott Gottlieb agreed, saying this crisis will require concerted action by a number of actors in federal, state and local government, as well as by partners outside of government.

FDA officials said they want to work with “other government agencies, health care providers, the medical products industry, policymakers, patients and their families” to attack the crisis.

To recover from the opioid epidemic, the nation must change the way it looks at opioids, said former FDA Commissioner Dr. David Kessler.

“In acute pain, they can be vital. Outside of that and outside of cancer pain, they are deadly,” he said. “We have to recognize that.”