SAFE Glen Cove Coalition: Opioid Epidemic Set to Escalate

The opioid epidemic could claim another 1.2 million lives in North America over the next seven years and widen globally without stricter regulation and revamped public health policies, according to a report conducted by the Stanford–Lancet Commission on the North American Opioid Crisis. The Commission was formed in response to escalating opioid-related morbidity and mortality in the USA and Canada over the past 25 years. The Commission is supported by Stanford University and brings together diverse Stanford scholars and other leading experts across the USA and Canada, with the goals of understanding the opioid crisis, proposing solutions to the crisis domestically, and attempting to stop its spread internationally.

Covid-19 has exacerbated the crisis. Since 1999, more than 600 000 people have died from opioid overdoses in the USA and Canada, and the current rate of mortality in each country exceeds even that of the worst year of the HIV/AIDS epidemic, increasing pressure on health systems and hampering access to services, the study showed. The loss of jobs, disabilities and deaths of family members and friends in some cases have led to greater drug use and addiction. Covid-19 has amplified all the risk factors and taken away a lot of the protective factors despite increased efforts to tackle the problem and heightened scrutiny of the industry. Researchers warned that the epidemic may continue to expand unless urgent steps are taken. Several countries targeted by the pharmaceutical industry, including the Netherlands, Iceland, England and Brazil, have seen increases in opioid prescribing in recent years, the researchers said.

Researchers maintain stronger regulation is needed to stop companies from exporting aggressive opioid promotion abroad, like the tobacco industry did when subjected to tighter rules in the U.S. and also called for efforts to curb over-prescribing and to reduce the industry’s influence on the government.

More than a dozen companies involved in opioids -- including manufacturers, distributors and pharmacies -- are facing thousands of suits filed by states, local governments and tribal leaders. The lawsuits seek compensation for billions of tax dollars spent battling the epidemic.

Johnson & Johnson and the three largest U.S. drug distributors recently agreed to pay about $590 million to more than 400 Native American tribes to settle lawsuits over the opioid epidemic. The companies are offering to pay a combined $26 billion to resolve all outstanding litigation. The agreement with the tribes would be part of that larger offer, which hasn’t yet been finalized.

Key recommendations of the Commission researchers are:

• The profit motives of key players inside and outside the health-care system will continue to generate harmful over-provision of addictive pharmaceuticals unless regulatory systems are fundamentally reformed.
• Opioids have a dual nature as both a benefit and a risk to health, function, and wellbeing. This dual nature should be taken into account in drug regulation, prescribing, and opioid stewardship.
• Integrated evidence-based systems for the care of substance use disorders should be developed and supported financially on a permanent basis.
• Policies are available that maximize the benefit and minimize the adverse effects of criminal justice system involvement with people who are addicted to opioids.
• Fostering healthier environments (eg, through programs for the safe disposal of opioid pills, substance use prevention, and childhood enrichment) could yield long-term declines in the incidence of addiction.
• Innovations in biomedical research into pain relievers and medications for opioid use disorder treatment, supply control strategies, and the delivery of treatment for substance use disorder are urgently needed in response to the opioid crisis.
• High-income nations have a responsibility to prevent their opioid manufacturers from fomenting opioid overprescribing in other countries, and all nations should consider how to strengthen regulatory systems to prevent domestically driven opioid crises.

The Lancet is a weekly peer-reviewed general medical journal. It is among the world's oldest and best-known general medical journals. For more information please visit www.thelancet.com.

The SAFE Glen Cove Coalition is conducting an opioid prevention awareness campaign entitled. “Keeping Glen Cove SAFE,” in order to educate and update the community regarding opioid use and its consequences. To learn more about the SAFE Glen Cove Coalition please follow us on www.facebook.com/safeglencovecoalition or visit SAFE’s website to learn more about the Opioid Epidemic at www.safeglencove.org.