Former CDC director Tom Frieden, MD, and Andrew Kolodny, co-director of opioid policy research at the Heller School for Social Policy and Management at Brandeis University in Waltham, Mass., shared 10 actions the federal government should take to address America's opioid overdose crisis in a paper published Thursday in JAMA.
The two experts open the paper by describing the nation's ongoing opioid crisis as the worst drug addiction epidemic in the country's history. Opioid deaths quadrupled between 1995 and 2010, according to the paper. By 2015, more than 33,000 people died of an opioid-related overdose in the U.S. More than 90 million people were issued an opioid prescription in 2015.
Here are the 10 steps Dr. Frieden and Dr. Kolodny laid out in the paper.
1. Improve surveillance of opioid addiction with real-time assessment of data, patterns and trends.
2. Improve quality and timeliness of response to opioid-related overdoses and fatalities by delivering better data to law enforcement and increasing funding for coroners and medical examiners.
3. Promote cautious opioid prescribing for acute pain by pushing the Food and Drug Administration to change opioid labels to reflect the CDC acute pain prescribing recommendations, which suggest a three-day supply is ample for acute pain, but exceptions of seven-day prescriptions will sometimes be warranted.
4. Greatly restrict or completely eliminate opioid prescriptions for chronic pain.
5. Expand insurance coverage and access for nonopioid and nonpharmacological pain medications.
6. Coordinate efforts between legal and public health officials to stem the international influx of heroin and deadly synthetic opioids like fentanyl into the U.S.
7. Incentivize states to identify possible opioid addiction in patients early and provide them access to treatment for substance use.
8. Expand access to medication-assisted opioid addiction treatments.
9. Promote harm reduction measures like access to naloxone and clean needles.
10. Consider banning ultra-high-dose opioids from the marketplace.
"The opioid addiction epidemic has worsened over the course of a generation and will not end overnight," the experts wrote. "Rapid implementation of the 10 steps outlined here could enable tracking and reduction of both new opioid addiction and fatal overdoses … the healthcare system has a responsibility to support actions … that could prevent addiction and save lives."
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