America's Opioid Crisis: A National Emergency?

Earlier this week, NPR published an article about a White House commission report that was released, urging President Trump to declare America’s opioid crisis a national emergency.1 The opioid crisis is considered by some to be a public health emergency and the article highlights the disturbing fact that drug overdoses now kill more people every year than gun homicides and car crashes combined.

So what would declaring a national emergency do and how would it combat the opioid crisis in America? This blog will answer these questions, as well as a few others you may have.

Statistics on Opioid Overdoses in America

  • The number of opioid overdoses in America has quadrupled since 1999.2
  • 91 Americans die every day from an opioid overdose.3
  • More than half a million people died from drug overdoses between the years of 2000 and 2015.3
  • More than six out of 10 drug overdose deaths involve an opioid.4
  • Although there has not been an overall change in the amount of pain Americans reported, the amount of prescription opioids being sold in America have nearly quadrupled since 1999.4  

What Is an Opioid Overdose?

Opioid drugs affect the area of the brain that regulates breathing. Therefore, when a person takes too much of an opioid or uses opioids with alcohol or sedatives, they may experience severe symptoms such as pinpoint pupils, unconsciousness, and respiratory depression. These symptoms are known as the “opioid overdose triad” and can result in death.5

Those most at risk for opioid overdose are people who have a reduced tolerance (due to recent detox, incarceration, or addiction treatment), people taking high doses of prescription opioids, people who inject opioids, people who have medical conditions, and people who are using opioids and alcohol or sedatives simultaneously.5 Although not all opioid overdoses are deadly, the risk of death is highest under the above-mentioned conditions.

What Is Naloxone and How Does It Work?

Naloxone is a solution that is injected or sprayed into the nose to prevent or reverse the effects of an opioid overdose. It is an opioid antagonist and has not been shown to produce any tolerance or physical/psychological dependence. It is a temporary drug and its effects wear off within 20-90 minutes.6,7

Why Declare a National Emergency?

Declaring a national emergency would give Health and Human Services (HHS) the ability to grant Medicaid waivers to states, which would provide more funding for inpatient drug treatment. Additionally, declaring a national emergency would allow the HHS to negotiate lower prices for Naloxone which would help state and local authorities make it more widely available.9

The interim report released by the White House commission also proposes using federal funds to expand the use of methadone and buprenorphine within medically-assisted drug treatment programs to help aid recovery and prevent relapse.1 As a result, this proposed action could potentially reduce the number of non-fatal and fatal opioid overdoses.

Are There Any Possible Negative Effects of Declaring a National Emergency?

The article published by NPR notes that some individuals are worried that declaring a national emergency would create a new version of the “war on drugs” declared by President Nixon in 1971. This well-known initiative and its drug policies resulted in claims of Congress passing overly excessive drug sentencing laws as well as the unfair targeting of minority communities.8 Some people also worry that those struggling with addiction may also be affected by heightened enforcement.9

What Else Can Be Done to Prevent Opioid Overdose Deaths?

The Centers for Disease Control and Prevention and the World Health Organization have recommended several ways we can prevent opioid overdose deaths. These include3,5:

  • Improve opioid prescribing practices by reducing unnecessary or inappropriate opioid prescriptions and limiting over-the-counter opioid sales
  • Increase access and availability of evidence-based substance abuse treatment
  • Expand access and use of naloxone
  • Utilize prescription drug monitoring program on the state level to help prevent drug abuse

 

References:

  1. https://www.whitehouse.gov/sites/whitehouse.gov/files/ondcp/commission-interim-report.pdf
  2. https://www.cdc.gov/drugoverdose/data/statedeaths.html
  3. https://www.cdc.gov/drugoverdose/epidemic/index.html
  4. https://www.cdc.gov/mmwr/volumes/65/wr/mm655051e1.htm
  5. http://www.who.int/substance_abuse/information-sheet/en/
  6. https://www.drugs.com/pro/naloxone.html
  7. http://harmreduction.org/issues/overdose-prevention/overview/overdose-basics/understanding-naloxone/
  8. http://www.history.com/topics/the-war-on-drugs

http://www.npr.org/sections/health-shots/2017/08/02/541071209/should-the-opioid-crisis-be-declared-a-national-emergency