Trying to get a handle on the evolving opioid epidemic has stakeholders at multiple levels in government looking for new approaches. To call it an epidemic and declared a crisis by the federal government is a reflection of data from the U.S. Department of Health and Human Services (HHS) that opioid-related deaths have increased more than five times in the past two decades.
The primary discussion has centered on prescription painkillers as an entry point to addiction and abuse. According to the Centers for Disease Control and Prevention, of the 42,249 opioid-related deaths in 2016, 40 percent were attributed to overdosing on prescription opioids.
But HHS data and healthcare policy experts also cite the pervasive infiltration of fentanyl into heroin, and more recently cocaine, making for a deadlier combination.
While bipartisan efforts are taking place in Congress to pass legislation, those efforts are mostly centered on creating stricter requirements on prescriptions and the use and enforcement of prescription drug monitoring programs into the clinical workflow.
At the state and local levels, new strategies are focusing on the individual. Because there are two different spaces where opioid-related deaths are occurring—prescription drugs and illicit drugs — it has become critical to reach addicted individuals and provide effective treatment. Such is the aim here in California of State Assembly member Dr. Joaquin Arambula (D-Fresno).
Dr. Arambula has introduced AB 2384, which proposes placing more emphasis on increasing access and availability of Medication Assisted Treatment (MAT) and reducing the stigma associated with drug use and addiction. Still awaiting a committee hearing, AB 2384 would require healthcare service plans to cover medication-assisted therapies and maintain one or more drug formularies to include, at a minimum, buprenorphine, methadone, naloxone, extended-release injectable naltrexone, and a combination of buprenorphine and naloxone. The bill also attempts to remove barriers to access by stating that MAT is presumed medically necessary. Among other provisions, the bill declares that access to treatment will not be subject to prior plan authorizations or annual or lifetime dollar limits.
California is not the only state searching for new strategies. Lawmakers in Oregon have passed a measure to initiate a pilot program through which opioid overdose victims are immediately placed into a treatment program and Utah launched an initiative promoting public awareness, education, and safe use of prescription opioids while also suggesting new ways to talk to patients about the issue. Minnesota is working with multiple medical technology players to develop alternative solutions to painkillers by controlling pain through neuromodulation devices. In Washington state, a biotech startup company is reporting favorable results in using venom obtained from a snail native to the Caribbean to help treat chronic pain.
Visit the following links for more information from the
CDC and HHS:
Data Overview | Drug Overdose | CDC Injury Center https://www.cdc.gov/drugoverdose/data/index.html
About the U.S. Opioid Epidemic https://www.hhs.gov/opioids/about-the-epidemic/index.html
Gabriela Villanueva is CAP’s Public Affairs Analyst. Questions or comments related to this article should be directed to gvillanueva@CAPphysicians.com.