Opioid overdose rates 'impossible' to ignore

(Medical Xpress)—Opioid over­dose now kills more people than both AIDS and homi­cides in America and has sur­passed auto­mo­bile acci­dents as the leading cause of acci­dental death in many states. According to the Cen­ters for Dis­ease Con­trol and Pre­ven­tion, the bur­geoning epi­demic accounts for approx­i­mately 16,000 deaths per year in the U.S.

"No one was talking about this problem a few years ago," said Leo Beletsky, a drug policy expert and assis­tant pro­fessor of law and health sci­ences at North­eastern Uni­ver­sity, "but it has now become impos­sible for public health and law enforce­ment offi­cials to ignore."

In an article pub­lished ear­lier this month in the Journal of the American Med­ical Association, Beletsky and physician-​​researchers Josiah Rich and Alexander Y. Walley called upon fed­eral agen­cies to take lead­er­ship in addressing this epi­demic through a com­pre­hen­sive series of public health-​​based initiatives.

The trio of researchers posits that the fed­eral government's cur­rent response to the growing public health crisis has focused too nar­rowly on restricting access to pre­scrip­tion and street drugs, an approach that has failed to pro­duce results. "We know from decades of expe­ri­ences in sub­stance abuse how dif­fi­cult it is to win bat­tles by focusing too nar­rowly on the 'supply' side of the equa­tion," Beletsky explained. "As things stand, not enough is being done to max­i­mize the oppor­tu­nity of saving lives."

A litany of bar­riers has con­strained the response, he said, including low public aware­ness of the signs of an over­dose; a shortage of Naloxone, an opioid antag­o­nist; and an unaware­ness or unwill­ing­ness on the part of pre­scribers to par­tic­i­pate in over­dose education.

Of the Naloxone shortage, Beletsky said, "Drugs like Naloxone that are cheap, generic and out of patent are more likely to be in shortage because they aren't per­ceived as a pri­ority for man­u­fac­turers." He called atten­tion to the issue in a recent Time Mag­a­zine article in which he was quoted.

In the paper, Beletsky and his col­leagues make more than a dozen rec­om­men­da­tions designed to improve the pre­ven­tion of fatal opioid over­dose. They call upon the National Insti­tutes of Health to eval­uate community-​​based naloxone access ini­tia­tives, for example, and for the Depart­ment of Jus­tice to for­mu­late and dis­sem­i­nate model leg­is­la­tion proving legal immu­nity to naloxone pre­scribers and lay respon­ders. They also sin­gled out the U.S. Food and Drug Admin­is­tra­tion, calling on the orga­ni­za­tion to require con­tin­uing edu­ca­tion pro­grams for health­care providers to cover over­dose prevention.

"Fed­eral agen­cies and policy-​​makers can and should take con­crete steps that could go a long way toward addressing this issue," Beletsky said. "We have seen a lot of suc­cessful exper­i­men­ta­tion in over­dose pre­ven­tion on the local and state level and now it is time for the fed­eral level to take the lead."