Seven steps to end the opioid crisis

Source: Seven steps to end the opioid crisis | Commentary |

Opioid overdose deaths rose 28 percent in 2016, to 42,000 men, women and children. Some 2.6 million more Americans are addicted to opioids, and communities in every region of the country are suffering from the resulting trauma. Largely as a result, life expectancy declined in 2016 for a second straight year — something that has not happened since the early 1960s.This is a solvable problem, and through philanthropy we can make some progress. But real success requires much bolder leadership — and a far greater sense of urgency — from both elected officials and industry leaders.   We must stop doctors from overprescribing opioids, especially when nonaddictive pain medications (such as ibuprofen or acetaminophen) would be just as effective.

Steps have been taken to educate doctors and to curtail prescriptions for opioids (such as Oxycontin, Percocet and Vicodin), and the prescription rate has fallen from its peak in 2010. But it remains three times what it was in 1999 — and four times what it is in Europe.More aggressive action is needed.

The Food and Drug Administration should allow only doctors who complete specialized education in pain management to prescribe opioids for more than a few days, a move FDA Commissioner Scott Gottlieb is considering. Some states have limited the size of certain opioid prescriptions — all should do so. To avoid the need for bans or other draconian measures, which would harm people suffering the most severe chronic pain (including many who are terminally ill), the medical profession must do more to rein in prescriptions and create effective monitoring programs.

Insurers and pharmacy benefit managers must better oversee opioid prescriptions. CVS Caremark has moved to limit coverage for opioid prescriptions. Others should follow its lead. These companies exist to help people lead better, healthier lives, and they should not be complicit actors in an addiction and overdose epidemic.


• We must hold pharmaceutical companies accountable for the supply of prescription opioids. Like gun manufacturers that continue to supply dealers with a history of selling to traffickers, pharmaceutical companies and their distributors have a history of turning a blind eye to pill mills. Local governments have filed nearly 200 lawsuits against manufacturers and distributors. They deserve their day in court, but we cannot pin our hopes on the outcome. The federal government must do more to monitor the supply of the drugs and crack down on companies that skirt the law.


• We must start treating those with addiction disorders when they come in contact with emergency rooms, hospitals and clinics. Too often, those who overdose are not offered long-term treatment — a regimen of buprenorphine, methadone or naltrexone — because the hospitals they are taken to do not provide it. Many walk out the door looking for their next hit, with fatal consequences. More funding is needed for treatment — and it may be that further state intervention is needed, too. Massachusetts Gov. Charlie Baker, a Republican, has proposed requiring overdose patients to be sent to treatment centers for up to three days in hopes of convincing them to accept longer-term treatment. Drastic times require drastic measures.


• We must stop stigmatizing the medications that have been proven to help people recover. Many politicians wrongly believe that providing methadone or other opioid-based treatment to people allows them to get high. In fact, when used as part of treatment programs, these medications address the symptoms of cravings and physical withdrawal without providing the euphoria of illicit drug use.