Is the US doing enough to combat the opioid crisis?

Each day, over 115 people die due to an opioid overdose. The opioid crisis is taking tens of thousands of American lives annually and is expected to cost the US over $1.5 trillion by 2021. Seven months after the opioid epidemic was declared a public health emergency, our elected officials have taken many steps to address “the crisis next door.”

Congress is currently considering a number of bills to address the opioid crisis, and S. 2680, the Opioid Crisis Response Act of 2018, sponsored by Sen. Lamar Alexander (R-TN), has gained the most traction. The bill passed through the Senate HELP Committee in April and is likely to reach the floor. It includes provisions to expand funding and flexibility for programs under several federal agencies, such as the FDA, CDC, SAMHSA, and NIH. Since only about 25% of bills are reported out of the HELP Committee, S. 2680 will be an important piece of legislation to track over the coming months.

Earlier this year, Congress approved funding to fight the opioid crisis, putting the federal government on track to spend a record $4.6 billion in 2018. But some experts say that is not nearly enough, given the scale of the epidemic. A report from the White House estimated the economic cost of the opioid crisis in 2015 alone to be over $500 billion. So how should these funds be used?

According to a survey of experts, around half of funding should go towards treatment programs. For those who emphasized the need for treatment, expanding access to medication-assisted treatment (MAT) was the top priority. MAT has long been touted as the best way to treat addiction and substance use disorders effectively. It involves combining FDA-approved medications designed to curb drug cravings with behavioral therapy and counseling. Though some of the money in the omnibus is to support treatment and prevention, a majority is geared towards preventing illegal drug imports and improving law enforcement efforts. President Trump has been a vocal supporter of implementing harsher punishments and supporting law enforcement at the US border.

Meanwhile, states are taking matters into their own hands. Several states have declared their own public health emergencies, and all of these have implemented some sort of restrictions relating to opioid prescribing or dispensing.

These states may run out of funding soon, though. Despite the aid provided by the 21st Century Cures Act, many states have been unable to decide how to use funding guaranteed for only two years to establish sustainable long-term treatment and prevention programs.

So the question remains: is the US doing enough?

By most accounts, the answer is no. Although the federal government is spending a substantial amount on the crisis this year, experts say it’s still far too little. Gary Mendell, founder and chief executive of anti-addiction advocacy group Shatterproof, felt that Congress’s original plan to allocate $45 billion over 10 years, averaging out to $4.5 billion annually, was “woefully, woefully short. What you need is funding flowing into the health care system, so that patients are treated by primary care doctors, by behavioral therapists, get medication-assisted treatment.” Our elected officials still have a long way to go before they can consider the US “liberated” from the opioid crisis.

For a closer look at the opioid epidemic, download our presentation: Understanding the Opioid Epidemic: At look at its origins, key players, and potential responses.