Cracking Down on Opioid Prescriptions is Driving the Opioid Crisis
Drug overdoses are now the leading cause of death among Americans under age 50. Driving this trend, which shows no sign of abatement, is a surge in opioid-related overdoses. The latest numbers for 2015 report a record 33,000 deaths, the majority of which are now from heroin. These types of deaths have occurred with such frequency that states — including Maryland, Florida, and Arizona — have declared medical states of emergency.
Earlier this week, President Trump convened a group of experts to give him a briefing on the “opioid crisis” and to suggest further action. Some, like New Jersey Governor Chris Christie, who heads the White House Drug Addiction Task Force, are calling for him to declare a “national public health emergency.” But calling it a “national emergency” only fosters an air of panic, which all-too-often leads to hastily conceived policy decisions that are not evidence-based, and have deleterious unintended consequences.
Many dangerous misconceptions persist around opioids, addiction, and chemical dependence.
Despite all the hype, prescription opioids are not that dangerous, even in heavy doses, when used under medical supervision.
Most opioid-related deaths do not occur via medically prescribed opioids. Instead, as doctors curtail their opioid prescriptions for pain patients, many in desperation seek relief in the illegal market. These alternate sources may be adulterated, of higher dosage than the user realized, or consumed with other drugs that generate adverse reactions.
Nonetheless, fears about opioid addiction drive restrictions on opioid prescribing, which, in turn, increase opioid poisonings.
While most states have made the opioid overdose antidote naloxone more readily available to patients and first responders, policies have mainly focused on targeted health care practitioners trying to help suffering patients, as well as efforts to cut back on the legal manufacture of opioid drugs.
The CDC has reported that opioid prescriptions are consistently coming down, while the overdose rate keeps climbing and the drug predominantly responsible is now heroin. But the proposals we hear are more of the same.
We need a calmer, more deliberate and thoughtful reassessment of our policy towards the use of both licit and illicit drugs. Calling it a “national emergency” is not the way to do that.
