There’s a blueprint for the president’s opioid commission

In March, President Trump announced the formation of an Opioid Commission to address the Nation’s troubling opioid epidemic.

Our Nation has been grappling with this issue for many years and significant steps have been taken to address the epidemic – from changing prescribing practices to increasing the availability of the opioid overdose antidote naloxone. 

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Of course, the issue has morphed over time and new challenges, such as the increase in illicit fentanyl, are upon us. As a former White House advisor on drug policy during the Obama Administration and co-author of the Administration’s 2011 plan to address the epidemic, there are additional steps that can be taken that will move us forward on stemming the tide of overdose deaths.

 

Keep it Bi-partisan. The policies that best address the epidemic are neither red nor blue. These policies have been guided by science, and efforts such as lifting the ban on Federal funding for syringe access programs or expanding treatment funding have received support from both sides of the aisle. 

Lead with Science

The bi-partisan 21st Century Cures Act authorized $1billion in funding for evidence based treatment. Research has shown that individuals have better outcomes if they are treated with medications approved by the Food and Drug Administration to treat opioid use disorder, along with psychosocial therapy. Focusing on expanding access to evidence based treatments can help bend the curve. 

Look to the Consequences 

While overdose is the most visible aspect of the opioid epidemic, there are other tragic consequences. These include increased rates of Hepatitis C (HCV) and human immunodeficiency virus (HIV) brought about by injection drug use. The Centers for Disease Control and Prevention identified 220 counties at risk for HCV and HIV outbreaks due to injection drug use. In addition, foster care rates in many states are on the rise as more parents suffer from substance use disorders.

Weave Public Health and Public Safety

Over the course of the epidemic, law enforcement has been on the front lines and they have understood that we cannot arrest our way out of this problem. Over the past several years, law enforcement agencies have expanded overdose prevention efforts by agreeing to carry naloxone to reverse overdoses. The North Carolina Harm Reduction Coalition reports that as of December 2016, over 1200 law enforcement agencies nationwide now carry naloxone. Law enforcement officials have also been sounding the alarm for more treatment availability and alternatives to incarceration through initiatives such as Police Assisted Addiction and Recovery Initiative (PAARI) and Law Enforcement Assisted Diversion (LEAD)

Look Around the Corner

Among the most vexing aspect of the opioid epidemic today is the growth in illicit fentanyl and increasing overdose deaths involving this powerful drug. Recent clusters of overdoses in some states have been largely the result of a surge in fentanyl availability. Traditional efforts to stem the supply of illicit fentanyl must be accompanied by efforts to identify why people are using fentanyl and what can be done to reduce fentanyl involved overdoses.

The Elephant in the Room

The debate over the repeal and replacement of the Affordable Care Act (ACA), raised concerns about the impact the replacement law would have on the opioid epidemic. Research conducted by Richard Frank of Harvard Medical School and Sherry Glied of New York University showed that repealing the ACA provisions providing substance use and mental health care coverage would eliminate approximately $5.5 billion in coverage to treat low-income people with these disorders.

Governor Chris Christie, Chair of the Commission, emphasized many of these elements, including evidence based prevention and recovery supports, while seeking solutions to the opioid epidemic in his home state of New Jersey.

Those affected by the epidemic are desperately seeking a way out of this epidemic and it is a positive sign that the Administration is sounding the alarm. The Commission’s work could make a difference in the lives of the hundreds of thousands of people who have lost loved ones if it emphasizes that this is a shared problem, demanding a shared solution.

Regina LaBelle was chief of staff at the White House Office of National Drug Control Policy until January 2017, and is currently working on a grant funded project for rural areas seeking to expand syringe access programs in at-risk areas.


The views expressed by contributors are their own and are not the views of The Hill.