Roosevelt Institute | Cornell University

Stopping the Disease in its Tracks, But This Time Without Painkillers

By Anna MalinowskiPublished November 5, 2017

The opioid epidemic exploding across the country is one of the nation's most pressing public health concerns. Its solution may, however, be rooted in public policy.

By Anna Malinowski

The CDC contends that of drug overdose deaths, over 60% involved an opioid, which now comes out to be about 91 opioid overdose deaths a day in America. Moreover, the number of prescription opioids sold, alongside the number of overdose deaths seem to have quadrupled from those of 1999. This crisis does not discriminate. It affects people in every state, from the most impoverished to the wealthiest, and within all racial categories (though white males are the largest demographic impacted).

Despite the fact that the problem at hand is growing, Trump has proposed to cut the National Drug Control Policy by 95 percent. Moreover, his administration is attempting to tear down the present healthcare system in favor of one that would make drug addiction harder and costlier to treat. While Trump has created a commission to divulge into this issue, the action seems contradictory to everything else he has been doing that would strip victims of this epidemic from their access to medical health and support. Moreover, his commission focuses on assessing the issue, but has disappointed in producing action and has even fallen short of declaring this issue to be a "national emergency", which many would argue it is.
While the blame for continuing to allow this epidemic to persist falls on the state and federal governments, significant responsibility also rests on the large pharmaceutical companies that recklessly market the drugs while downplaying their addictive influence in order to increase sales. According to an article from The Atlantic titled, "Are Pharmaceutical Companies to Blame for the Opioid Epidemic?", in Ohio, the state with the largest number of overdose deaths involving opioids, there were 793 million doses of opioids prescribed. The article suggests that this figure is "enough to supply every man, woman, and child, with 68 pills each." The argument here is that in the interests of boosting sales, pharmaceutical representatives fail to fully disclose the impact some opioids can have on patients, and doctors are not fully informed on the best opioid prescribing practices. Thus, both state and federal legislatures can start by criminalizing this practice. It's common knowledge that pharmaceutical reps are paid by commission and work with high sales goals to meet. This makes it tempting to use unethical sales practices to boost numbers and criminalization of the misrepresentation of the nature of such drugs can be a strong determent from this kind of behavior.

A second and equally important initiative to take is to halt the assault on Medicaid. Thirty percent of nonelderly adults with opioid addictions are covered by Medicaid. In 2013, there were 636,000 people who were both opioid addicts and Medicaid enrollees. The health insurance program not only provides care to those addicted to opioid drugs but it also enables states to do the same. The Henry J. Kaiser Family Foundation, a health care focused non-profit organization, contends that 1 in 5 people with opioid addictions are uninsured, often because they live in states without sufficient expansion of Medicaid coverage. Medicaid and states can work together to go beyond providing medication, by making available inpatient and outpatients programs, counseling and therapy, and case management/coordination among other services. This would first require the expansion of Medicaid, of course. This is especially important since those on Medicaid typically lack the resources needed to acquire the necessary tools themselves.

The role of the government here needs to be advocacy. Big Pharma needs to be stopped from perpetuating the epidemic by pushing more opioids into the market. For those for whom it's too late, the government needs to ensure that they can receive adequate care and support in battling their addiction. These two steps will be pivotal in curbing the climbing death rate and stop addiction in its tracks.