A Rights-Based Approach to the Opioid Epidemic in the United States
The opioid epidemic in the United States claims the lives of 130 Americans on average every day Drug overdose is now the leading cause of death of people under the age of 50 — a figure higher than fatalities by guns or car accidents.
This national health tragedy has been taking the lives of Americans for decades. Between 1999 and 2017, almost 400,000 people died from an overdose involving any opioid , including prescription and illicit opioids. In 2017 alone, the opioid epidemic killed 70,000 people , according to a new report in Health and Human Rights Journal .
According to the U.S. Centers for Disease Control and Prevention which tracked the epidemic for some time now, the first wave of deaths can be traced back to the late 1990s when doctors began over-prescribing opioids. The second wave began in 2010, with a sharp spike in heroin-overdose-related deaths. In 2013, as illicitly-manufactured fentanyl swept the market, more and more overdose deaths involved these synthetic opioids.
As deaths skyrocketed back in 2010, authorities clung to the view that overdose deaths were a symptom of criminal activity or immoral behavior.
“ People continue to die from this long-standing health crisis because addiction is still treated in this country as a “‘moral failing or criminal behavior, “ noted Dr. Sarah Wakeman, medical director with the Massachusetts General Hospital Substance Use Disorder Initiative in Boston, a recent article in AMA Journal of Ethics .
She continued, “People with an illness must be treated, not punished.”
How can we protect the rights of people snared in the opioid epidemic? A sharper focus on treatment, education and criminal justice reforms is a promising start, argues a new report in Health and Human Rights Journal . It maps out crucial steps to turn the tide of deaths.
Among its recommendations: A mass shift away from prescribing opioids for long-term pain relief. “Taking prescription opioids for longer periods of time or in higher dosages can increase the risk of addiction, overdose, and death,” the report warns. Although the rate of opioid prescriptions is falling, in 2017 there were still 58.7 prescriptions for every 100 individuals , per the CDC. The report urges doctors to consider non-opioid alternatives, such as physical therapy, biofeedback and non-opioid medications.
The report encourages policymakers and elected leaders to make the overdose-reversal drug naloxone more widely available to save lives. Some pharmacies already offer naloxone without a prescription in many states. This practice should be universal, the report argues. It also advocates for educating regular citizens to administer naloxone. It notes that new federal legislation, modeled on an Illinois state law, is necessary to shield Good Samaritans who administer naloxone from being sued.
The report argues the nation can no longer view the opioid epidemic in the United States as a criminal justice issue or moral failing. National leaders must treat it as the health crisis it is. This requires:
- Equipping law enforcement officers with drug treatment options. Hundreds of law enforcement agencies in 31 states are already part of a Police Assisted Addiction ad Recovery Initiative. This program offers treatment for drug users who ask authorities for help, but many communities still lock up opioid users — often denying them proven recovery medications such as methadone, naltrexone and buprenorphine.
- Treating mental issues related to opioid use. More than half of people with substance abuse problems also suffer from mental health conditions like depression and post-traumatic stress. These conditions make them more likely to relapse. Under the Mental Health Parity and Addiction Equity Act of 2008, insurers must cover the same level of benefits for mental health and addiction that they do for other medical therapies. Still, some insurers impose arbitrary treatment limits or make patients jump through hoops to get coverage.
- Expanding Medicaid in the 14 states that rejected the coverage under the Affordable Care Act. Medicaid expansion has given countless low-income adults access to addiction and mental health treatment at no cost. This care is saving lives. Since Ohio adopted Medicaid expansion, overdose deaths in one Ohio county alone plummeted by more than half in just one year. In 2018, the country witnessed 294 overdose deaths — down from 566 overdose deaths the previous year.
The list of solutions is hopeful, but circumstances are dire and action is imperative. By one account, someone dies in this country from an overdose every 11 minutes . The report cautions, “There is no time to waste.”
Opiate addiction hotlines are lifelines to many who feel their opiate addiction is out of control. If you or someone you know is struggling opioid addiction, call this hotline for help: 1-877-721-5607
Nicole Knight is a freelance writer based in Southern California. A former reporter for the Orange County Register, she most recently covered issues related to women’s health and economic justice for the nonprofit site Rewire.News. Her bylines have appeared in outlets ranging from Pacific Standard to Parents.com, reflecting her varied interests. She is a member of the Association of Health Care Journalists and the American Society of Journalists and Authors. Follow her on Twitter @nicolekshine.
Originally published at https://medtruth.com on March 8, 2019.