The nation’s opioid epidemic has been the focus of former President Obama’s administration. According to the Centers for Disease Control and Prevention (CDC), opioids played a role in 33,091 deaths in 2015. This figure is linked to the use of prescription opioids that are being prescribed for non-cancer chronic pain. Since there is insufficient medical evidence that opioids improve chronic pain, the CDC published guidelines in March of 2016, for prescribing opioids for non-cancer pain. The guidelines recommend the use of non-opioid therapies, such as behavioral or exercise based, whenever possible. If opioids will be prescribed, the lowest effective dose should be prescribed for the briefest period of time. Regular follow up is also needed to ensure that the benefits of the opioids exceed the risks.
In addition to the new guidelines, the CDC encourage states to run prescription drug monitoring programs (PDMPs) in order to allow prescribers and pharmacists to better regulate the dispensing of opioids. Several states that have implemented these programs have shown a decrease in certain opioid overdose deaths. These states include Florida, New York, Tennessee and Oregon.
Joining the CDC in the battle to curb opioid abuse is the US Surgeon General, Dr. Vivek H. Murthy. His office launched the “Turn the Tide”, nationwide campaign, in 2016 in order to bring awareness to and end the opioid epidemic. Dr. Murthy has stated: “We have to stop treating addiction as a moral failing and start seeing it for what it is: a chronic disease that must be treated with urgency and compassion.” This statement signals a significant departure from the way opioid use disorder was previously viewed by many. The campaign also focuses on reaching out to health care providers in order to encourage them to comply with the CDC guidelines for prescribing opioids and serve as leaders in the battle against opioid abuse. Physicians are encouraged to use medication assisted treatment (MAT) when they have identified patients with an opioid use disorder and seek to prevent overdoses. Dr. Murthy and his office have also gone on a nationwide tour to meet with those affected by the epidemic and discuss various effective practices with community leaders.
The Comprehensive Addiction and Recovery Act (CARA) signed into law on July 22, 2016 is yet another weapon in the battle against opioid abuse. It seeks to address the opioid epidemic by providing for the following: expanded prevention of opioid use through education programs, expanded availability of naloxone to law enforcement agencies and first responders, expanded treatment for incarcerated individuals with addiction disorders and expanded disposal sites for opioids in order to prevent them from being misappropriated. The Act also seeks to: develop evidence based opioid and heroin treatment and intervention programs, MAT and intervention demonstration programs and strengthen PDMPs in states.
Although the Act authorizes over $181 million each year in new funding for the program, the funds must come through the regular appropriations process. Given the administration change, the degree of funding is uncertain. There should however be support for it since Representative Tom Price, President-elect Trump’s chosen Secretary of the Department of Health and Human Services, voted in favor of the CARA legislation. Vice President -elect Pence similarly expressed his support of treatment and recovery for those addicted to opioids when he, along with 44 other governors in the National Governors Association, signed a compact to address this in July of 2016.
The opioid epidemic is far from over. It can however be managed through the implementation of the CDC guidelines as urged by the Surgeon General in the Turn the Tide campaign. The passage of the CARA Act, with its sweeping directives, further shows a strong commitment of the nation to end the epidemic.