A year since its annual death toll surpassed that of the entire Vietnam war, three months since it was declared a public health emergency and mere weeks since it was named a reason for the decline in American life expectancy, we’re still no closer to solving the opioid epidemic.
Opioids continue to kill a record-high 1,000 Americans every week. At the same time, as global life expectancy increases, the U.S. is projected to have the lowest life expectancy among high-income countries by 2030.
The staggering number of American lives ended or diminished by the opioid crisis is entirely preventable. While federal and state agencies have made some promising plans to prevent further deaths, efforts have so far been disconnected and largely focused on treatment. Now, states are calling for better coordination, and more importantly, a sense of urgency.
Governors Call for State-Federal Partnership
The National Governors Association (NGA) made an announcement last week about the consequences of opioid addiction on states and communities, including a shrinking workforce and overwhelmed healthcare providers. State governors asked President Donald Trump’s administration to commit more funding and action to the problem.
So far, the Trump administration has pledged to help states pay for drug treatment through Medicaid. The Department of Justice also caught illegal imports of fentanyl last year.
On the other hand, the administration hasn’t yet moved beyond “discussions with Congress on the appropriate level of funding needed to address this crisis,” according to a spokesperson. Mike Bloomberg, former mayor of New York City (where more citizens died last year from opioid overdoses than from car accidents and homicides, and new lawsuits aim to recoup the costs) argues the crisis has not been treated as an emergency at all.
Democrats have also criticized Trump for appointing 24-year-old Taylor Weyeneth as deputy chief of staff at the Office of National Drug Control Policy (ONDCP), which, along with the Drug Enforcement Administration, still lacks a permanent director. The NGA denied that this appointment had any influence over its announcement, but said more should be done.
Among the NGA’s two-dozen recommendations was increased access to both naloxone, a major but seriously underprovided antidote that reverses opioid overdoses, and methadone, which can help treat dependency. In terms of treatment, governors say the federal government should require drug prescribers to monitor prescription databases and complete substance abuse training, as well as do more to stop illegal imports of opioids. The NGA also asked the White House to appoint someone to lead a coordinated strategy.
A White House spokesman said the administration will continue to work with states toward coordinated solutions. But what about promised initiatives that haven’t been followed through? What about the increasing numbers of communities joining the national multidistrict litigation for damage already inflicted by opioid drugmakers?
Judge to Step in With ‘Meaningful’ Action
Days after appointing a team of lawyers to manage the MDL lawsuit earlier this month, the federal judge overseeing this litigation called a hearing to push the team toward a settlement plan. U.S. District Judge Dan Polster aims to dramatically reduce the number of opioid pills on the market and resolve all pending litigation this year.
“My objective is to do something meaningful to abate this crisis, and to do it in 2018,” Polster said. “With all these smart people and their clients, I’m confident we can do something to dramatically reduce the number of opioids that are being disseminated, manufactured and distributed.”
MDL lawyers face challenges in reaching a settlement quickly, but hope tools like the DEA’s pharmaceutical sales data will help. Polster, too, hopes to have DEA and FDA officials participate. Lawyers say they expect litigation to help staunch the flow of opioid deaths. However, Polster noted, his courtroom should not have to shoulder responsibility for solving a national crisis.
“Ideally, this should be handled by the legislative and executive branches, our federal government and state government,” he said. “They haven’t seemed to have done a whole lot. So, it’s here.”