Additional Measures Needed for a Comprehensive Public Health Approach to the Opioid Crisis
An outcome- and evidence-based approach is needed to combat the rising rates of opioid-related fatalities in the United States.
In an effort to address the ongoing opioid crisis adequately, a set of measures complementing the current efforts at state and federal levels would need to be implemented for a more “coordinated and comprehensive approach” to the issue, according to the authors of an editorial published in the Annals of Internal Medicine.
An outcome- and evidence-based approach is needed to combat the rising rates of opioid-related fatalities in the United States. Such strategies should include expansion of prescription drug monitoring programs (PDMP) and medication-assisted treatment and increased naloxone availability, with the goal of reducing death rates, alleviating impact on families, reducing the supply of legal opioids, improving the availability of medication-assisted treatment programs, preventing substance abuse, and expanding opportunities for treatment and recovery.
The authors' proposed approach consists of 6 key elements:
- Leadership, by ensuring the engagement and support of community leaders and legislators and public and private healthcare stakeholders and by establishing a shared perspective for addressing opioid abuse
- Partnership and collaboration, by establishing clear goals and engaging relevant stakeholders (eg, clinicians, community groups, insurers, and social services) and supporting cross-sector collaborations
- Epidemiology and surveillance, by promoting data collection and sharing (eg, PDMP data), developing indicators, standardizing reporting of overdoses, and customizing response efforts
- Education and prevention by building community awareness on addiction and associated stigma, implementing prevention programs in schools and communities, mobilizing communities, limiting the supply of opioids (eg, through pain management education for clinicians, and mandatory use of PDMPs and greater sharing of PDMP data)
- Treatment and recovery by improving accessibility to evidence-based substance use disorder treatment and recovery programs, improving the identification of risky behaviors, and enforcing mental health parity laws
- Harm reduction and overdose prevention by expanding programs for syringe exchange, safe drug disposal, and naloxone distribution
“The elements of our approach are meant to guide action in domains where public health agencies can and should lead. We suggest that the combination of these strategies in 1 coherent public health approach that is tailored for regional cultures and contexts will have a lasting effect in states and communities,” noted the study authors.
Levine M, Fraser M. Elements of a comprehensive public health response to the opioid crisis. Ann Intern Med. 2018;169:712-715.