More than half a million people in the United States and Canada have died from an opioid overdose, and a new study estimates that 1.2 million more could die by 2029 if drastic solutions are not found. not enacted by government to reform and regulate the industries that administer and facilitate the use of opioids.
Stanford University created the Standford-Lancet Commission on the North American Opioid Crisis in response to skyrocketing opioid-related death rates in the United States and Canada over the past 25 years. In a new analysisthe commission identified a range of problem areas where governments could act, from reforming drug regulations, building stronger systems for substance use disorders, promoting healthier environments for the prevention of substance use and the encouragement of innovation in biomedical research for analgesics.
The commission argues that the opioid crisis in North America began when “insufficient regulation of the pharmaceutical and health care industries allowed for-profit opioid prescribing to quadruple.”
This has been clarified in recent years, as Purdue Pharma, maker of the opioid OxyContin, pleaded guilty to conspiracy to obstruct the Drug Enforcement Administration (DEA) which also involved facilitating illegal prescriptions of OxyContin.
Pharmaceutical giant Johnson & Johnson suffered the same fate, with a judge ruling company must pay $572 million to alleviate the ongoing opioid epidemic in the state of Oklahoma. Evidence presented at trial revealed that Oklahoma doctors were targeted more than 150,000 times by J&J sales reps, aggressively marketing them and bombarding them with pseudoscience and misleading information that downplayed the risks of opioids .
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The committee noted that under U.S. law, once a drug is approved, monitoring and educating prescribers about its risks is largely at the discretion of the manufacturer, as well as any post -marketing of approved opioid drugs. This is set to change, as the commission recommended that the government step in and monitor the risks or harms of drugs after approval and be more willing to remove non-compliant drugs from the market.
The commission also found that the United States does not spend enough on treatment programs for substance use disorders and that previous studies have found that less than half of treatment programs have a doctor or nurse in attendance. full-time on staff, which “shows how poor the treatment is. system for substance use disorders is integrated into mainstream medicine.
The federal government has historically funded substance use disorder programs through short-term grants, but this has created weak and inconsistent funding. As a result, the commission argued that this may reduce the willingness of clinicians to specialize in the care of substance use disorders and of educational institutions to provide training in this area.
To address this issue, the commission recommended integrating sustainable, evidence-based systems for the management of substance use disorders that are built and financially supported on an ongoing basis. It also includes adapting the mindset on how to deal with drug addiction, such as the controversy around supervised drug consumption sites.
New York City took a step in that direction last year when former Mayor Bill de Blasio announced the first publicly recognized overdose prevention centers. The sites are considered safe places for people who use drugs to receive medical care and be connected to treatment and social services. The city one The Ministry of Health conducted a feasibility study and found that opening overdose prevention centers would save up to 130 lives a year.
Another recommendation from the commission was to spur innovation in response to addiction, writing that other chronic health conditions like depression, asthma, hypertension and cardiovascular disease have seen better treatment options. over the past 25 years, but not addiction treatment.
“Innovation is also needed in pain management, particularly in the development of effective drugs that do not carry the risk of addiction,” the commission’s report said.
The gist of the commission’s report found that even in the age of COVID-19, “the opioid crisis stands out as one of the most devastating public health disasters of the 21st century in the United States and Canada. “. He warned that addiction will remain a problem among the population, but in the future the main drugs of concern may not be opioids.
“It took more than a generation of mistakes to create the North American opioid crisis. It may take a generation of wiser politicians to solve it. Such policies will have lasting gains if they reduce the power of health systems to cause addiction and maximize their ability to treat it,” the commission said.
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