Health Literacy,  News,  Treatment

The Opioid Crisis: a National Public Health Emergency

Medication Pills

In mid-October, Ex-DEA Agent Joe Ranazzisi appeared on 60 Minutes to expose details of how pharmaceutical lobbyist and the US Congress have worked in conjunction to knowingly derail DEA efforts at curtailing the opioid epidemic.

“Rannazzisi accuses the distributors of fueling the opioid epidemic by turning a blind eye to pain pills being diverted to illicit use,” says 60 Minutes correspondent Bill Whitaker to the viewing audience.

Then, to Rannazzisi, he asks: “You know the implication of what you’re saying, that these big companies knew that they were pumping drugs into American communities that were killing people?”

“That’s not an implication,” responds Rannazzisi, “that’s a fact. That’s exactly what they did.”

President Trump responded to the whistleblower’s interview by declaring the opioid epidemic a national public health emergency. In earlier interviews spanning as far back as August, Trump promised that he would declare the epidemic a “national emergency” as opposed to a “public health emergency”, and this has drawn ire from a few. Julie Hirschfeld Davis writing for The New York Times reports:

“The move falls short of Mr. Trump’s sweeping promise to declare a national emergency on opioids, which would have triggered the rapid allocation of federal funding to address the issue, and does not on its own release any money to deal with the drug abuse that claimed more than 59,000 lives in 2016… But it would allow some grant money to be used for a broad array of efforts to combat opioid abuse, and would ease certain laws and regulations to address it.”

Sen. Edward J. Markey, D-Mass., is also critical of the Trump administration’s handling of the situation, saying that “America is hemorrhaging lives by the day because of the opioid epidemic, but President Trump offered the country a Band-Aid when we need a tourniquet.”

The Trump administration’s argument is that a “national emergency label” would have been too broad and not the right label for a lasting crisis — the designation of “national emergency” is usually reserved for major national disasters. Nevertheless, the declaration of the opioid crisis as a national public health emergency will push us further toward a solution than no declaration at all.

Pushing Further Toward a Solution

According to Politifact, the Trump administration’s declaration of a national public health emergency will allow the federal government to do the following:

  • Accelerate temporary appointments of specialized personnel to address the emergency (pending any funding needed)
  • Work with the Drug Enforcement Administration to expand access for certain groups of patients to telemedicine for treating addiction
  • Provide new flexibilities within HIV/AIDS programs

Unfortunately, appointing specialized personnel is extremely ambiguous, and the only one of these bullet points that comes close to finding a solution to the problem, let alone treatment for those who are suffering. If those struggling had better access to tried-and-true methods of treatment, such as medication-assisted treatment via implants, there would be far fewer addicts on the streets. Of course, this would likely be expensive, as well as reliant on the addict to seek help themselves.

We don’t know exactly how to address the opioid epidemic at its core — there’s still a lot of debate as to who is responsible and to what degree. If Rannazzisi is correct, that means the government as well as the pharmaceutical industry are going to have to take a long hard look at themselves. For everybody else, that means making hard choices.

Doctors and health care administrators already deal with a myriad of ethical dilemmas daily — add to that list whether or not to prescribe or supply pain medication for fear of misuse and abuse and you’ve got quite the conundrum. The hippocratic oath says to first “do no harm,” but saving a patient from addiction on one hand could mean increased and unnecessary patient suffering on the other. Patient education alongside restrictive medication is likely the best bet, but isn’t an end-all be-all.

Hopefully, the federal government will conjure a solution soon. More than 183,000 Americans have died by overdosing on opioids between 1999 and 2015, with numbers reaching as high as an estimated 65,094 between March 2016 and March 2017, according to the CDC. Those numbers will only continue to rise until the opioid epidemic has finally been stemmed.

Andrew Heikkila is a tech enthusiast, a futurist, and a business owner from the Pacific Northwest. He believes in the power of technology to guide the world in the right direction, but also understands human fallibility means it won't always be used to these ends. Still, he has hope that people will transcend their natural devices, and become the beings we have the potential to be.

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