COVID-19 has garnered much of the media attention in the past 18 months, but it is not our only public health emergency. The United States also has seen an astronomical spike in overdose deaths in the past year.
As we celebrate National Recovery Month, we also must recognize all the work yet to be accomplished to prevent overdoses and increase the number of people entering long-term recovery.
The National Office of Drug Control Policy reported that more than 90,000 people died of overdose deaths in America during 2020, which is up over 25% from 2019, according to the U.S. Centers for Disease Control and Prevention. In West Virginia alone, overdose deaths were up nearly 56%, from 852 in 2019 to 1,326 in 2020.
While federal funding through state opioid response grants has flowed into our state, which has been hit disproportionately hard by prescription opioid distribution and the flow of illicit drugs, this money is not enough. We should treat the disease of addiction with the same vigor and determination as we do with disease outbreaks, like COVID-19.
The early response to COVID-19, which included a national-emergency declaration to allow for emergency drug and vaccine approval, reimbursement for telemedicine, free point-of-care testing and vaccines, and increased funding to states to mitigate the economic effects, allowed for a rapid deployment of lifesaving interventions across the country.
We must prioritize our national response to the opioid epidemic in the same way, to save our fellow citizens struggling with addiction who deserve the same lifesaving, crosscutting national prioritization of their disease.
Immediate and direct action is needed, to curb overdoses and increase the number of Americans entering treatment and maintaining long-term recovery. We cannot afford to continue to lose progress in addressing the opioid epidemic in the midst of a global pandemic. We urge President Joe Biden and his administration to reauthorize the public health emergency around opioid addiction and implement the following four actions.
- First, immediately make the overdose-reversal drug, naloxone, an over-the-counter medication, using the Defense Production Act, if needed, and provide federal funding to ensure access free of charge, just as is done with COVID-19 vaccinations.
Naloxone is a safe, lifesaving drug that has fewer side effects than many over-the-counter medications. In April 2021, a manufacturing issue halted Pfizer’s production of single-dose injectable naloxone at a time when overdoses had reached an all-time high throughout the nation. We must reduce the obstacles of supply and cost while allowing widespread distribution of naloxone.
- Second, we must remove the DEA-X training requirement. Although substance use of all types is on the rise, opioid use disorder is the deadliest. Opioid use disorder is a treatable disease, although, unfortunately, it often is easier to prescribe powerful opioids than it is to prescribe medications for opioid use disorder because of barriers such as the DEA-X requirement.
Medications have been shown to reduce overdose deaths, keep families together, reduce criminal behavior and improve workplace performance and retention.
In January 2021, the U.S. Department of Health and Human Services made prescribing medications to treat addiction easier, but urgent change is needed to immediately reduce unnecessary barriers to these lifesaving drugs.
As we reduce the prescription of addictive drugs, we must provide evidence-based treatment solutions for people dependent on opioids. We ask that funding be dedicated to require all medical training programs to incorporate addiction training into their curriculum, while fully repealing the DEA-X requirement in the national emergency declaration.
- Third, during the pandemic we have seen significant increases in substance-use related overdoses and mental health disorders.
In addition, the National Council of Behavioral Health reported that 77% of counties in the United States are experiencing a severe shortage of mental health providers. The National Center for Health Workforce Analysis projects that, by 2025, there will be a 45,000- to 250,000-person shortage in mental health professionals.
A national-emergency declaration should address this shortage by expanding mental health training programs and mandating a national standard for a mental health worker minimum wage, so that poor communities that often struggle disproportionately with increased addiction burden are not competing directly for the necessary workforce with richer areas.
West Virginia recently had a substance use disorder program for pregnant and postpartum women close due to staff shortages, despite significant demand for these services. The need to address this shortage is imminent with COVID-19 and the increase in overdose and substance use in our country.
Finally, we must address the root causes of substance use disorder, including economic disparity.
We cannot continue to ignore that overdose is a symptom of more than the disease of addiction — it’s a desperate cry for help from our most disadvantaged communities. Under an emergency declaration, all future infrastructure and economic development funding should be directed to the counties hardest hit by the opioid epidemic, to transform the economies of these largely rural areas into the economic engine they have the potential to be.
During Recovery Month, we must double down on our efforts to help those who are not yet in recovery. A colleague recently put this in perspective by sharing that America lost 58,000 servicemembers in the 21-year Vietnam War. In this past year alone, we lost a record 93,000 people in the United States to opioid addiction.
These are American lives worth saving.
The time to act is now.