On October 26, 2017, the US Department of Health and Human Services (HHS) declared the ongoing opioid crisis a public health emergency, which allows $57,000 from the Public Health Emergency Fund to be used to combat the addiction epidemic. Although not designated a national health emergency, President Trump’s new plan of action to tackle the situation includes setting up patient access to telemedicine for areas in short supply of doctors, giving grants to help addicts struggling to find work, hiring more staff to the HHS, and accessing funds from HIV treatment programs, as HIV and opioid addiction share a sizeable patient base.
To demonstrate why the Centers for Disease Control and Prevention (CDC) declared the opioid addiction crisis an epidemic in 2011, one must only look at the statistics. In 2015, there were 33,000 deaths due to opioid overdose (including prescription drugs and illegal opioids such as heroin), with almost half believed to be due to prescription painkillers alone. 2016 saw an alarming increase to 59,000 deaths due to overdoses, and there are currently estimated to be 50,000 doses taken per day per million patients requiring painkillers. Because of this, President Trump’s declaration has been a long time coming. However, critics continue to argue that although the move has been a positive step for increasing awareness of the issue, it does not give individual states adequate funding to deal with the problem.
There are many causes of the epidemic. US healthcare insurance companies have a preference for prescribing pills to treat painful conditions instead of paying for more costly, but sometimes more appropriate, treatments such as physiotherapy. Pharmaceutical company reps push their companies’ products to doctors, this activity correlates with an increase in prescription of those drugs and, in 2016 doctors were paid $8 billion by Pharma to push their products. TV advertising also has a significant impact on the total number of painkillers prescribed, as along with the hopes of doctors to keep their patient ratings high by prescribing the powerful drugs.
There are several measures that are being called for to combat the epidemic, including measures preventing over-prescription of opioids, calls to improve doctor training in pain management and management of addiction. Anti-addiction organisations have also recommended that the HHS lower the price of naloxone, a drug used to counteract the effects of opioid overdose, or even make an over-the-counter version. Perhaps most challenging is the need to shift the perspective of opioid overdosing as a criminal act to that of a chronic medical issue.