“We would never tolerate a situation where only one in 10 people with cancer or diabetes gets treatment, and yet we do that with substance-abuse disorders,” (A)

“Having recognized the widespread and devastating nature of the opioid crisis, governors are taking action to stem the tide of opioid use disorder and overdose.
States are uniquely positioned to do this work, because they play a central role in protecting public health and safety; regulating health care providers; establishing prescription drug monitoring programs (PDMPs); and paying for care through Medicaid, state employee benefits, corrections and other health programs. Current evidence suggests that the most effective way to end the opioid crisis is to take a public health approach focused on preventing and treating opioid use disorder as a chronic disease while strengthening law enforcement efforts to address illegal supply chain activity. This road map uses a public health intervention model to guide state activities in targeting the problem with health care and law enforcement strategies. A monitoring and evaluation component is included to help states assess the effectiveness of those efforts and inform future activities.” (B)

“President Donald Trump declared the opioid crisis a national emergency Thursday, a designation that would offer states and federal agencies more resources and power to combat the epidemic.
In a statement released late in the day, the White House said, “building upon the recommendations in the interim report from the President’s Commission on Combating Drug Addiction and the Opioid Crisis, President Donald J. Trump has instructed his Administration to use all appropriate emergency and other authorities to respond to the crisis caused by the opioid epidemic.”
“The opioid crisis is an emergency, and I am saying, officially, right now, it is an emergency. It’s a national emergency,” Trump said earlier at his golf club in Bedminster, New Jersey. “We’re going to spend a lot of time, a lot of effort and a lot of money on the opioid crisis. It is a serious problem the likes of which we have never had.”
Trump’s actions come just two days after Health and Human Services Secretary Tom Price suggested declaring a national emergency was unnecessary.
“We believe that at this point, the resources that we need or the focus that we need to bring to bear to the opioid crises can be addressed without the declaration of an emergency,” Price said, “although all things are on the table for the president.” “(C)

“The chairman of the president’s opioid commission, New Jersey Gov. Chris Christie, thanked the president “for accepting the first recommendation” of the commission’s report.
“It is a national emergency and the president has confirmed that through his words and actions today, and he deserves great credit for doing so,” Christie said.
It’s not exactly clear what making the declaration will mean for federal efforts to combat the opioid crisis. But a number of states say similar declarations have helped.
The commission’s report to the president said a declaration “would empower your cabinet to take bold steps and would force Congress to focus on funding and empowering the Executive Branch even further to deal with this loss of life.”” (D)

“For the past 50 years, we have been waging a war on drugs that has relied nearly exclusively on supply control and tough punishment. It hasn’t worked.
Despite the logic of limiting the availability of drugs and threatening and punishing those who are involved in the drug trade and using drugs, the report card for this tough method of enforcement is bleak. We have invested more than $1 trillion during the past 45 years in the war on drugs. Yet there is essentially no evidence in support of the success of that effort.
Why has it failed? The medical community declared nearly 70 years ago that drug and alcohol addiction and dependence are medical disorders. We can’t punish diabetes or cancer away. So why do we think getting tough on addiction would work?
To complicate the landscape, approximately 40% of opioid-dependent individuals have depression, anxiety, or bipolar disorder, and some have other co-occurring psychiatric disorders. Post-traumatic stress disorder and personality disorders are also present, though less frequently. Punishment is not only ineffective; it often exacerbates these mental health problems.
Punishment also does not deter those with substance use disorders. Today, the vast majority of individuals who enter the U.S. criminal justice system have problems with drug addiction, dependence, or abuse. The recidivism rate for those with such disorders is nearly 80%. The reason is simple: Punishment does nothing to address drug abuse, dependence, or addiction.
It’s time to stop disregarding scientific and clinical evidence and get realistic about how we should address the drug problem. The evidence is unequivocal—we cannot effectively control supply. There is simply too much money to be made on the sale of illicit drugs.
We should therefore recalibrate drug policy by dramatically ramping up evidence-based strategies of demand reduction. The only way to reduce the incidence of substance use disorders is effective treatment. Ideally, that should occur outside the confines of the justice system with community-based treatment. Those who end up in the justice system should be diverted to treatment, not simply locked up.
Drug abuse is a public health problem. It is time we treat it that way. (E)

 

Some updates:
“Companies that make or distribute opioid painkillers are facing a “tidal wave” of litigation as US officials seek to raise funds to fight the country’s addiction epidemic and punish those they accuse of fueling the crisis.
The number of government officials launching legal action against drugmakers and wholesalers has soared in the past year in what some lawyers see as a harbinger of a settlement that could echo the more than $200bn extracted from the tobacco industry in 1998.
At least 30 states, cities and counties have either filed lawsuits or are formally recruiting lawyers using a process that tends to prelude full-blown legal action, according to a Financial Times analysis.” (F)

“……. Republicans are still considering making dramatic cuts to Medicaid that would severely handicap efforts to overcome the opioid epidemic. Now more than ever, we need to ensure that resources are available to help those struggling with opioid addiction, and Medicaid is the backbone to support these efforts.” (G)

 

 

(A) Landmark report by Surgeon General calls drug crisis ‘a moral test for America’, by Lenny Bernstein, https://www.washingtonpost.com/national/health-science/landmark-report-by-surgeon-general-calls-drug-crisis-a-moral-test-for-america/2016/11/16/4214bf2a-ac49-11e6-977a-1030f822fc35_story.html?utm_term=.3adfcafb8a98
(B) Finding Solutions to the Prescription Opioid and Heroin Crisis: A Road Map for States, National Governors Association, https://www.nga.org/files/live/sites/NGA/files/pdf/2016/1607NGAOpioidRoadMap.pdf
(C) Trump: ‘The opioid crisis is an emergency’, by Wayne Drash and Dan Merica, http://www.cnn.com/2017/08/10/health/trump-opioid-emergency-declaration-bn/index.html
(D) Trump Says He Intends To Declare Opioid Crisis National Emergency, by Brian Naylor and Tamara Keith, http://www.npr.org/2017/08/10/542669730/trump-says-he-intends-to-declare-opioid-crisis-national-emergency
(E) Trump Clearly Has No Clue How to Stop the Opioid Epidemic, by William R. Kelly, http://fortune.com/2017/08/09/trump-opioid-briefing-speech-crisis-epidemic-war-on-drugs/
(F) Drug industry faces ‘tidal wave’ of litigation over opioid crisis, David Crow, https://www.ft.com/content/36e93cee-7e39-11e7-9108-edda0bcbc928
(G) SERIOUS ABOUT THE OPIOID CRISIS? THEN DON’T SLASH MEDICAID, by DOUG WIRTH, http://www.newsweek.com/serious-about-opioid-crisis-then-dont-slash-medicaid-649222

 

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