The Lancet Responds to the Opioid Crisis in North America

There are a number of pressing issues facing the healthcare system today, but arguably the biggest issue is the opioid crisis. This is an epidemic that has impacted countless people throughout the United States and Canada, but despite the best intentions, the crisis continues to get worse. Recently, a comprehensive study was published in The Lancet, titled “Responding to the Opioid Crisis in North America and Beyond: recommendations of the Stanford Lancet Commission.” The commission released a number of recommendations that could be helpful in curbing the impacts of the opioid epidemic.

The Current Status of the Opioid Epidemic

The side effects of opioid and narcotic recommendations are well-known. They can lead to respiratory depression (overdose), addiction (opioid use disorder), and a range of mental health issues. During the past few decades, a crisis emerged when a lack of sufficient regulations allowed pharmaceutical companies and the healthcare industry as a whole to profit greatly from the prescription of opioid medications. Essentially, pharmaceutical companies incentivized hospital systems and medical practices to prescribe more opioid medications to drive revenue growth. The result is that many people who may not have required opioid medications were exposed to them, increasing the number of people who developed substance abuse and addiction concerns.

According to information published by the Department of Health and Human Services:

  • In 2018, more than two out of every three drug overdose deaths involved an opioid or narcotic medication.
  • Since 1999, more than 760,000 people have died of a drug overdose.
  • In 2019, more than 10 million people over the age of 12 misused opioids.

Clearly, these numbers show that the opioid epidemic is still a significant problem. The Stanford Lancet Commission released a number of recommendations, broken down into domains, that are designed to address many of the issues related to the opioid crisis.

Domain 1: The U.S and Canadian Opioid Crisis as a Case Study in Multi-System Regulatory Failure

The first domain is related to removing the influence of the pharmaceutical industry on numerous elements of the healthcare system. Some of the main recommendations include:

  • Reduce Industry Influence on Prescribers: The first goal is to reduce the influence of the industry on prescribers. This can be done by removing promotional pharmaceutical products and separating medical education from the influence of the pharmaceutical industry.
  • Reduce Industry Influence on Regulators: The next goal is to reduce industry influence on regulatory officials. The pharmaceutical industry should not oversee its post-approval and risk mitigation processes, and the pharmaceutical industry should not put its former officials on regulatory boards.
  • Reduce Industry Influence on the Political Process: The pharmaceutical industry should not have influence over the political process. Steps must be made to limit fraudulent advocacy groups, and pharmaceutical companies must be limited in their ability to donate to political campaigns.

Domain 2: Opioids’ Dual Nature as Both a Benefit and Risk To Health

Steps must be made to better acknowledge the benefits and risks of opioid medications. More studies must be conducted to provide prescribers and patients with the knowledge they need to appropriately use opioid medications.

Furthermore, the adverse impacts of opioid medications on the treatment of chronic pain must be anticipated. Policy changes must be made on a subpopulation level to protect people who might be harmed by them.

These changes can go a long way toward increasing opioid stewardship medicine, restoring the trust of physicians in opioid medications, and using opioid agonist therapy (Medication Assisted Treatment) appropriately.

Domain 3: Building Integrated Systems for the Treatment of Substance Use Disorders

Many changes have been made in the treatment of opioid abuse and addiction treatment during the past few years. These systems need to be solidified to ensure everyone has the social support they need to access substance abuse and addiction treatment. Public and private insurance companies must better finance the care of substance use disorders while also curtailing the use of harmful treatment options. Furthermore, medical professionals should get access to continuing education regarding the treatment of substance use disorders. This can remove barriers to substance abuse treatment.

Domain 4: Maximize the Benefits of Criminal Justice and Minimize the Harm

Changes also need to be made to the criminal justice system. Individuals should not be incarcerated for simple opioid possession, as this could make the crisis worse. Furthermore, individuals need to be provided with medication-assisted treatment during and after incarceration.

Furthermore, penalties should be removed for substance use during pregnancy, and collateral penalties should be removed for drug-related crimes. By shifting the focus from punishment to rehabilitation, it is possible to break the cycle of addiction leading to incarceration and provide individuals access to the help they need instead of simply punishing them.

Domain 5: Create Healthy Environments That Lead To a Decline in Addiction

Steps must be made to foster a healthy environment that can reduce the long-term rate of addiction. Some of the ways to create a healthier environment include:

  • Create safe disposal programs for superfluous opioids
  • Substance abuse programs need to be integrated with other behavioral programs that better teach children about the dangers of opioid and narcotic medication
  • More programs must be aimed at low-income families to provide extra help to those at a greater risk of opioid abuse and addiction

Domain 6: Foster Innovation To Respond To Addiction

Steps also have to be taken to foster a more innovative response to fight addiction. A few possible examples include:

  • Public policies must make up for failures in patent law
  • Drug companies need to redesign opioid medications to reduce the risk of addiction while still treating chronic pain
  • Fentanyl transactions need to be targeted using innovative strategies that can disrupt this dangerous problem
  • A federal agency needs to brainstorm new approaches to the opioid crisis. The goal should be to target dangerous behaviors instead of simply punishing individuals

Domain 7: Looking Beyond North America

Steps also need to be taken to stop the movement of illicit opioid medications beyond North America. Pharmaceutical companies should not use corrupt opioid promotion practices to export fraudulent medications. Furthermore, generic morphine should be distributed to low-income nations for analgesic purposes. By stopping the growth of opioid epidemics beyond North America, it is possible to make people in the United States and Canada safer.

Trust the Professionals at MATClinics

At MATClinics, we stay up to date on the latest recommendations on substance abuse and addiction, particularly those that involve narcotics and opioids. We would be honored to help you as well.

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