The current prevalence of opioid abuse is not a secret, especially with overdose deaths on the rise nationwide. Increasingly problematic occurrences are sweeping across the country. Even worse, the rapid explosion of opioid use shows no signs of stopping. The states most affected seem to be Ohio, West Virginia, Kentucky, and Indiana. To say politicians and lawmakers are taking notice is an understatement; mayors, governors, and Congress members are calling for increased support and additional funds. In many states, cuts to Medicaid mean cuts to health care coverage for those facing opioid addiction. And, as the healthcare debate continues, the ever-increasing reality of heroin and prescription opioid use is significant indeed. For some time during the health care repeal effort, a package of billions of dollars was on the table for opioid addiction assistance. However, no such funds went toward the relief effort.
For the longest time, many states have referred to these drug use trends as a state of emergency. It was only recently that President Trump declared the opioid epidemic a national emergency. Although this announcement came with no plans for the assistance, this declaration may be the spark we need. With luck, this declaration could be the start of additional programming required to fight back against opioid abuse from coast to coast.
The State of Opioid Use in America
From abuse of prescription drugs to the rise in tainted heroin making its way across the U.S. border, the current state of opioid use is extremely troubling. According to the CDC, 12.5 million people misused prescription opiates in 2015, while 2 million suffered from a prescription opioid use disorder and 33,091 people died due to opioid overdose. Whether legally or illegally, nearly one in three Americans used painkillers in some way. Furthermore, approximately 828,000 people used heroin – 135,000 for the first time – with 12,989 overdose deaths attributable to heroin use. In total, these patterns of use led to $78.5 billion in economic costs, creating costly problems in every state. These costs relate back to healthcare, addiction treatment, lost productivity, and criminal justice services.
As of June 2017, approximately 90 Americans die each day from overdosing on opioids. Additionally, rates of Hepatitis C and neonatal abstinence syndrome are on the rise. As such, additional demands are being made of the already-strained health care system.
What Caused the Opioid Epidemic?
The causes driving the opioid epidemic in the United States are both diverse and complex. With problems arising from both illegal heroin and legal prescription painkillers, officials are left with a two-pronged battle to fight. A key contributing factor involves the higher rate of painkiller use that began in the 1990s. Due to ease of use and effectiveness alike, doctors nationwide increased prescription rates, offering new and powerful painkillers to thousands upon thousands of patients. Pharmaceutical companies assured that new and powerful opioid analgesics would not lead to addiction issues. However, the opposite proved to be true, setting the foundation for the challenges seen today.
Today, approximately 20% to 30% of patients prescribed opioids for chronic pain misuse them, and 8% to 12% develop an opioid use disorder. Of these individuals, roughly 4% to 6% make the switch to heroin. This is primarily due to the lower cost and increased availability. In fact, 80% of those who abuse heroin first misused opiates.
The State of Emergency
On Thursday, August 10th, in a press conference given from the Trump National Golf Club in Bedminster, New Jersey, President Trump confronted the reality of the U.S. opioid epidemic by declaring it a national state of emergency. This announcement came just two days after his first mention of the opioid crisis, in which he acknowledged its severity but failed to declare it an emergency of national proportions.
“You know when I was growing up they had the LSD and they had certain generations of drugs,” he stated, explaining his views on the current state of affairs. “There’s never been anything like what’s happened to this country over the last four or five years. And I have to say this in all fairness; this is a worldwide problem, not just a United States problem.”
Despite this firm stand against drug abuse, the President was not the first politician to declare a state of emergency. Six states that were strongly affected have already done the same. In fact, they’ve requested federal aid to stop the growth of this disturbing pattern. Former Massachusetts governor Deval Patrick was the first, declaring opioid abuse as a public health emergency in 2014. Maryland Governor Larry Hogan made the call in March after a record 550 overdose deaths occurred in the first quarter of 2017. In response, the state has cracked down on prescription policies and granted a waiver allowing Medicaid to pay for inpatient rehabilitation. Governor Rick Scott of Florida called for aid in May, subsequently allocating $27 million for addiction treatment and prevention. In June, Arizona Governor Doug Ducey followed suit, as did officials from Alaska and Virginia.
What This Means
So, now President Trump has determined that the opioid epidemic is an emergency of national proportions. What exactly does this mean?
The answer, unfortunately, is still unclear.
Despite his statement, President Trump did not outline exactly how he plans to address the opioid crisis. He also did not mention what he will do to aid states in need. So, before moving forward, the White House must appropriately classify the declaration. It will most likely be through the Stafford Act or the Public Health Services Act. While the outcome will be similar regardless of the path selected, the declaration method utilized dictates where funding comes from and how it is applied.
A Presidential commission on opioid use stated in its interim report that outlining this crisis as a national emergency will allow the administration to move forward swiftly while sending a message to Congress regarding the urgent need for more funding. However, no actual plan concerning opioid treatment has been put into place yet. Also, the availability of funding has thus far not been discussed by the White House, the House of Representatives, or the Senate.
Fighting Back Against Opioids
The U.S. Department of Health and Human Services, as well as the National Institute of Health, have taken minor steps forward in the war against opioid abuse. According to government reports, their five major priorities are as such:
- Improved access to treatment and recovery services
- Promotion of the use of overdose-reversing drugs like naloxone
- Raising awareness of the dangers involved in current opioid use
- Providing support for increased research on pain medication addiction
- Advancing pain management practices to reduce dependency on pain medication in treatment
Despite these statements, the progress made and the plans behind these intentions are largely unknown. With no method currently used to quantify success, these measures are, at best, a long-term strategy to implement change rather than a short-term response to the newly-declared state of emergency.
While the declaration of a state of emergency is ultimately a positive step forward, a simple announcement isn’t enough to get the ball rolling. Without future action behind the President’s words, the situation is unlikely to see any immediate improvement. Nevertheless, addiction professionals hope to see clear direction from the President over the coming months and years, including an increase in available federal funds and the development of recovery programs designed to target those in need.
Addiction is always a serious issue, no matter the substance in question. If you or someone you love is struggling with addiction, help is available. Give Outpatient Services a call today at (844) 211-7944 to learn more about what our team of addiction professionals has to offer.