COMBATTING THE OPIOID CRISIS
Opioid overdose and deaths are one of the most urgent public health threats facing cities and communities throughout the country. Presently, drug overdose is the leading cause of accidental death in the U.S. and drug overdose rates are increasing – among men and women of all ages and races . The opioid epidemic is a cross-cutting national problem, with all 50 states and the District of Columbia experiencing increases in drug misuse and overdose rates. Overdoses, from either prescription or illicit opioids, have led to over 33,000 deaths nation-wide in 2015, and over 40,000 deaths in 2016. The opioid related death toll is expected to rise again in 2017. Thus far, the epidemic has cost the United States over $78.5 billion.
POLICIES & PRACTICES
U.S. opioid-related fatalities have quadruped in the past 20 years and still on the rise. It is imperative that cities promote and implement proven strategies to prevent, treat and combat the opioid health crisis. Below is a snapshot of best and promising practices, programs, and/or policies that have shown strong results in combatting the crisis.
SAFE PRESCRIBING GUIDELINES FOR HEALTH CARE PROVIDERS
Safe prescribing guidelines and training improve the way opioids are prescribed through clinical practices that ensure patients have access to safer, more effective chronic pain treatment, while reducing the number of people who misuse, abuse, or overdose from these drugs.
ONLINE TRAINING FOR PROVIDERS
The CDC's Division of Unintentional Injury Prevention (DUIP), launched the first in a series of interactive, online trainings for healthcare providers. These trainings feature the recommendations in the Guideline for Prescribing Opioids for Chronic Pain, providing sample scenarios, feedback, and resources. This series is intended to help healthcare providers communicate effectively with patients about opioid use, decide when to initiate or continue opioid therapy, offer appropriate non-opioid options for pain management, as well as assess and address the harms of opioid use. Addressing the Opioid Epidemic: Recommendations from CDC, the first training in the series, is available for continuing education credit and can be found on the training web page.
PRESCRIPTION DRUG TAKE BACK PROGRAMS
Drug take back programs provide a safe, convenient, and responsible means of prescription drug disposal. Timely disposal of prescription drugs prevents future drug misuse by youth, family pets and adults who inadvertently consume leftover medications.
PUBLIC EDUCATION & AWARENESS CAMPAIGNS
Public education consists of providing community members with knowledge of how to safely store, use and dispose of prescription medications with considerations for long-term health and safety. Public education and awareness campaigns help consumers understand what opioids are, the effects, signs and symptoms of addiction, and where to go to receive help. According to the National Institute of Drug Addiction, each dollar spent on research-based prevention programs can save up to $10 in treatment costs for alcohol and other substance abuse disorders.
PRESCRIPTION DRUG MONITORING PROGRAMS
Prescription Drug Monitoring Programs (PDMPs) are electronic databases used to track the prescribing and dispensing of controlled prescription drugs to patients. They help to support safe opioid prescribing by identifying and protecting patients at risk for addiction. In most cases, PDMPs are operated by states.
NALOXONE DISTRIBUTION & TRAINING
A number of states across the U.S., and cities where authorized, have issued standing orders to increase the distribution and availability of Naloxone – a lifesaving overdose reversal drug. A standing order is a physician’s order that can be carried out by other health care workers when predetermined conditions have been met. Under this model, a doctor with prescriptive authority issues a written order that naloxone can be distributed by designated people. This allows harm reduction outreach workers to train drug users and their loved ones on overdose response and then equip them with naloxone without a doctor being present.
SUPERVISED INJECTION SITES
Supervised injection sites are legally sanctioned facilities where drug users can inject pre-obtained drugs under medical supervision. These facilities prevent vulnerable users from experiencing a drug overdose and provide disease testing, rehabilitation services, counseling, and treatment that put vulnerable users on pathways to recovery.
SYRINGE EXCHANGE PROGRAMS
Syringe exchange programs allow for civilians who are likely to inject drugs to access sterile needs and syringes without a prescription. These programs prevent the spread of communicable diseases, serve as outlets to behavioral change services and programs, and offer treatments and vaccinations for vulnerable populations.
GOOD SAMARITAN LAWS
Good Samaritan laws provide immunity from prosecution related to drug possession charges for overdose victims and those who call for help. These laws are designed to encourage users and bystanders to contact the authorities in the event of a potential overdose.
These laws are often enacted at the state level, though some localities have passed their own legislation, when they possess the authority to do so.
Medication-assisted treatment (MAT) is the use of medications in combination with counseling and behavioral therapies for the treatment of substance use disorders. A combination of medication and behavioral therapies is effective in the treatment of substance use disorders, and can help some people to sustain recovery.
Addiction does not discriminate and Baltimore officials believe that all citizens should have the capacity to save a life. The program is built on the belief that naloxone should be part of everyone's medicine cabinet and everyone's first aid kit.
- Harm Reduction Coalition
- Centers for Disease Control & Prevention: Injury Prevention Center – Opioid Overdose
- Winter 2017 issue of NACCHO Exchange, “On the Frontlines: Local Public Health versus America’s Opioid Epidemic”
- State of the Opioid Epidemic: Local Public Health as the First Line of Defense
- Drug Policy Alliance
- Centers for Disease Control & Prevention Health Impact in 5 Years (HI-5): Access to Clean Syringes
- Legal Interventions to Reduce Overdose Mortality: Naloxone Access and Overdose Good Samaritan Law
- The Network for Public Health Law Explains: using law to support pharmacy naloxone distribution.
- An Example of a Standing Order for Dispensing Naloxone Rescue Kits to Individuals at Risk of Experiencing or Witnessing an Opioid Related Overdose
- National Alliance for Model State Drug Laws
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Note: These are highlights of selected activities going on in cities across the country, and are not meant to be comprehensive.