Guest Commentary

All Americans can help fight the opioid epidemic

Kansas Attorney General Derek Schmidt and U.S. Surgeon General Jerome Adams
Kansas Attorney General Derek Schmidt and U.S. Surgeon General Jerome Adams

America faces an unprecedented opioid crisis, but we may be turning a corner.

Due to a rapid surge of illegal synthetic opioids — such as fentanyl and carfentanil — the Centers for Disease Control and Prevention estimate deaths in 2017 increased by almost 10 percent, claiming the lives of more than 70,000 Americans. But today, Facing Addiction in America: The Surgeon General’s Spotlight on Opioids, shines a light on the latest data for prevalence of substance misuse, opioid misuse, opioid use disorder and overdoses.

The Spotlight gives us reason for hope. For example, between 2016 and 2017, the nation saw a significant increase in the use of MAT, or Medication Assisted Treatment — the gold standard for treating opioid use disorders. In addition, we saw a national reduction in the rate of heroin initiation. Federal, state and local efforts are having an impact, but we must do more.

The Surgeon General’s Spotlight tells us that the public health community has strong science to treat pain, prevent addiction, facilitate recovery and reverse overdoses. In addition, the public safety community has laws to deter trafficking, curtail overprescribing and reduce diversion. Two specific interventions requiring cross-system collaborations are drug courts and the overdose-reversing medication, naloxone. As part of a comprehensive opioid strategy, these tools can impact the lives of people who misuse, their families and the first responders and health professionals who serve them.

In virtually every state and territory and in many tribal communities, treatment courts reduce recidivism, promote public safety and improve public health. Through more than 3,000 treatment courts in the United States today, nearly 150,000 Americans gain access to life-restoring services such as MAT, instead of being held behind bars. As a result, these individuals, their families and our communities are safer, healthier and economically stronger. Well-administered drug courts — particularly those that partner with both behavioral health and law enforcement — reduce recidivism by as much as 45 percent, reduce drug use, improve health outcomes (including for babies of women with opioid use disorder) and save an average of $6,000 for every person served.

As an influx of synthetic opioids in the illicit drug supply has increased America’s overdose deaths, public safety leaders are working to stay ahead of the ever-evolving supply chain. For example, the National Association of Attorneys General recently endorsed proposed legislation to make fentanyl analogues illegal. In addition, the surgeon general issued a rare public health advisory to encourage more Americans to carry naloxone.

Congress, the White House, the Departments of Justice and Health and Human Services and state, local and tribal governments have expanded efforts to make naloxone more available. All states have passed naloxone-access laws and, in the vast majority of states, individuals can purchase naloxone without a prior prescription. In addition, most states have laws designed to protect healthcare professionals prescribing and dispensing naloxone from civil and criminal liabilities as well as Good Samaritan laws to protect people who administer naloxone or call for help during an opioid overdose emergency.

Recent polling shows the majority of Americans would use this life-saving medication. States are leading initiatives to harmonize good Samaritan laws, expand insurance coverage to include third parties likely to encounter an overdose and increase co-prescribing of naloxone to patients receiving high-dose opioid prescriptions for chronic pain. Since January 2017, the number of naloxone prescriptions dispensed on a monthly basis has nearly tripled.

In recognition of September as Recovery Month, we urge all Americans to join the fight against addiction and to support recovery. To this end, the Surgeon General also released a digital postcard, highlighting five tangible actions that all Americans can take to raise awareness, prevent opioid misuse and reduce overdose deaths. Steps you can take include:

Talk about opioid misuse. Have a conversation about preventing drug misuse and overdose.

Be safe. Take opioid medications only as prescribed. Make sure to store medication in a secure place and dispose of unused medication properly.

Understand pain and talk with your health care provider. Treatments other than opioids can be effective in managing pain.

Understand that addiction is a chronic disease. With the right treatment and supports, people do recover.

Be prepared. Get and learn how to use naloxone, an opioid overdose reversing drug.

Derek Schmidt is Kansas attorney general and immediate past president of the National Association of Attorneys General. Jerome Adams is surgeon general of the United States.
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