https://goo.gl/e679wB
The United States is in the midst of the worst drug addiction epidemic in its history. Prescriptions for and deaths from opioids both quadrupled between 1995 and 2010. By 2015, an estimated 92 million individuals in the United States were prescribed an opioid and there were more than 33 000 deaths from an opioid-involved overdose.1
There are no simple solutions to ending this epidemic. Effective programs need to address 2 separate priorities: (1) prevention of addiction among people not currently addicted, and (2) treatment and risk reduction to prevent overdose and death among the millions of individuals in the United States now addicted. In this Viewpoint, we suggest 10 steps that could accelerate progress; national declarations, state-specific emergency declarations, or both could potentially facilitate implementation of these steps.2
1. Improve surveillance of possible opioid addiction
2. Improve reporting of and response to opioid-related overdoses and fatalities
3. Promote more cautious prescribing for acute pain
4. Change labeling for chronic pain and greatly restrict or eliminate marketing of opioids for this indication
5. Increase insurance coverage of and access to nonopioid and nonpharmacological management of pain
6. Interrupt the supply of heroin and illicitly produced synthetic opioids and improve coordination between legal and public health authorities (not going to happen)
7. Identify possible opioid addiction early and link individuals to treatment
8. Expand low-threshold access to opioid agonist treatment, particularly with methadone and buprenorphine
9. Implement harm reduction measures for current users, including access to clean syringes and naloxone
10. Consider removing ultra-high-dosage-unit opioid analgesics from the market