In a bid to curb the opioid crisis that is killing some 40,000 Americans each year, the Trump Administration unveiled on Wednesday a $1.8 billion grant package to bolster treatment and prevention efforts. The funding will be awarded in a series of grants, and used to improve access to treatments for those who have overdosed on opioids, as well as to gather data across the United States that relates to opioid use and overdose.
The Centers for Disease Control and Prevention (CDC) will be given $900 million to spend over three years, and the Substance Abuse and Mental Health Services Administration will be awarded around $932 million to support prevention, treatment and recovery services. The funding will be complemented by continued efforts to combat the epidemic, including increasing illegal opioid seizures, awareness raising through national campaigns, reducing the high cost of drug prescriptions and improved reporting of opioid-related deaths. President Trump said when unveiling the package that his administration was also spending “a great deal of money” finding a non-addictive painkiller.
America’s opioid addiction problem was officially declared a public health emergency in 2017, the result of almost three decades of healthcare providers handing out prescriptions for opioid pain relief as though they were cough lozenges. At that time, the medical community had been assured by pharmaceutical companies that such pain relievers were not addictive, and so increased prescription rates lead to widespread misuse of both prescription and non-prescription opioids – ultimately resulting in a national crisis when it was found such medications were indeed highly addictive.
Wholesale distributors and retail manufacturers of opioids, including Purdue Pharma, Janssen Pharmaceuticals (a subsidiary of Johnson & Johnson) and Endo International are now facing major lawsuits raised by thousands of governmental entities, who are suing them in order to recover the immense damages they have sustained as a result of the misadvice. The claims allege the companies knew the drugs were being overly prescribed and of the inherent risks of overprescription, yet failed to warn doctors of the highly addictive nature of such medication. Last month, an Oklahoma judge fined Johnson & Johnson $572 million for its role in the crisis, in the first step in what promises to be many years of complex litigation.
According to the CDC, almost 130 Americans now die every day from opioid-related drug overdoses, and more than 1,000 are treated in emergency departments across the country for opioid prescription misuse. In 2017, 191 million prescriptions for opioid pain medication were handed out by national healthcare providers – working out to be 58.7 prescriptions per 100 people. And of those people who were given opioid prescriptions that year, more than 11 million misused them. The toll on human life aside, opioid is also placing a huge economic burden of $78.5 billion a year on the country, including the costs of addiction treatment, health care, lost productivity and criminal justice costs.
Perhaps the scariest reality of America’s opioid crisis is the hand that primary care physicians appear play in the problem: despite having been issued guidelines to reduce the amount of opioid prescriptions being given out, in 2017 prescriptions were involved in more than 35 percent (or 17,000) of all opioid overdose deaths.
The Trump Administration has introduced a number of measures to stem the crisis in recent years, from Introducing the ‘Safer Prescribing Plan’ which aims to cut opioid prescription fills by one-third within three years, and through implementing the SUPPORT Act or ‘Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities Act’, the largest legislative package to address a single drug crisis in history. But is it helping?
According to the CDC, drug overdose death figures have dropped 5.1 per cent in 2018 from 2017 in the U.S, suggesting the government’s efforts to curb opioid use disorder and addiction are working. Previously, deaths caused by opioid overdose had risen every year from 1999 to 2017, with a sharp spike between 2014 and 2017.
The number of first-time heroin users ages 12 and older also fell by more than 50 per cent in July 2017, and high-dose opioid prescriptions fell by 16 per cent between January 2017 and October 2018. There has also been a 20 per cent increase in young adults receiving outpatient treatment for opioid addiction. However, fatalities linked to synthetic opioids like fentanyl – which has since flooded the U.S. market and is roughly 100 times stronger than opioids – rose in 2018, as did deaths attributed to methamphetamine and cocaine. Furthermore, it has been found that the overwhelming majority of deaths related to opioid overdose in recent years appear to have been people who used mixtures of drugs. In 2013, 94 percent of the people who died from heroin or other opioids in New York City had mixed drugs in their system. And, according to Albert Einstein College of Medicine’s Chinazo Cunningham, the number of prescription opioid overdoses is actually shrinking year on year, but overdose rates have not plateaued because heroin use is rapidly increasing.
There is no denying the opioid crisis is a national crisis and health epidemic. But the solutions may not be quite as straightforward as simply mending the doctor-patient relationship in respects to the overprescription of opioid medication.