As opioid overdose deaths continue to rise, report urges lawmakers to develop new approaches
WASHINGTON. Lawmakers should view America’s staggering opioid crisis, including the rise in fentanyl trafficking, from an “ecosystem” perspective, the RAND Corporation said in an extensive report released Thursday.
That means they must look into gaps and interlinkages between emergency response, data collection, education, treatment, housing and law enforcement, the report says.
The 600-page volume, which the authors describe as “perhaps the most comprehensive analysis of opioids in 21st-century America,” encourages federal, state, and local lawmakers to think “beyond traditional silos” and invent innovative ways to curb the adverse effects of addiction and growing addiction. Drug overdose deaths among Americans.
“There were a lot of initiatives and efforts to try to solve this problem, but when we looked around, we saw that most, not all, but most seemed to fall into bunkers – like: “We are going to improve treatment” or “We are going to focus on harm reduction” or “We are going to reduce illicit use and try to reduce supply,” said Bradley Stein, director of RAND’s Center for Opioid Policy, Tools and Information.
RAND, headquartered in Santa Monica, California, is a non-profit organization that focuses on several areas, including the US military, education, homeland security, and health care.
“One of our actions was that we kind of took a step back and asked: “Are there any possibilities between these systems, between the bunkers? So, thinking about it more like an ecosystem or more holistically, are there things and opportunities that we might be missing out on?” said Stein, one of the authors who works at the RAND office in Pittsburgh.
The number of overdoses has increased dramatically in recent years.
According to a study by the Centers for Disease Control and Prevention released in December, drug overdose rates in the US have risen five-fold over the past two decades.
The study shows that opioid-related deaths, including synthetic opioids such as fentanyl and its many analogues, are steadily increasing, with a staggering increase in recent years.
The CDC tracked a record 107,622 overdose deaths in 2021, of which 71,238 were caused by artificial, illegal fentanyl substances.
The agency defines drug overdose death as death resulting from “unintentional or intentional overdose of a drug, ingestion of the wrong drug, ingestion of a drug by mistake, or ingestion of a drug unintentionally.”
Illicit fentanyl found in other drugs, such as counterfeit prescription pills, cocaine and heroin, has been targeted by federal agencies and the subject of numerous congressional hearings and roundtables.
GOP members on the U.S. House of Representatives Committee on Energy and Commerce are poised to flag the Fentanyl Termination Act, a measure reintroduced in this Congress by Republicans Morgan Griffith of Virginia and Bob Latta of Ohio.
The bill seeks to permanently classify fentanyl analogs as Class I substances under the Controlled Substances Act.
Just this month, a bipartisan group of US lawmakers, including Democrats Joe Negus of Colorado and Madeleine Dean of Pennsylvania, organized the Fentanyl Prevention Caucus.
The group plans to educate and destigmatize the opioid overdose drug Naloxone, said Dean, who has spoken publicly about her son’s recovery from opioid addiction.
Not enough data
One gap legislators face when trying to make a decision is the lack of data. The US is essentially “flying blind,” the RAND report says.
“We’ve had this opioid crisis for a while, but if we look across the country, there are still all these areas where we still don’t have a clear idea of the extent of the problem. How many people use fentanyl, how many people use heroin?” Stein said.
The report argues that user stigmatization, the unintended consequences of criminal penalties and lack of communication between systems prevent the collection of clear data that could improve people’s quality of life in other areas, such as housing, child protection and employment.
Still, some state and local governments are developing ways to combine data, Stein said.
The report notes that Maryland linked data on health care, drug treatment, criminal and legal statistics, and mortality information.
Rhode Island has collected several datasets, including valuable information collected on non-fatal overdoses and naloxone distribution networks, in one data center.
The Pennsylvania Opioid Data Dashboard, among other things, tracks the number of doses of naloxone administered by EMS personnel and the number of emergency room visits for opioid overdoses.
Tim Leach, vice president of Pittsburgh Firefighters Local 1, responds to varying drug overdose emergency call volumes that vary based on local drug use trends.
“Usually we meet with the patient first. As soon as we get there and start treating the patient, the paramedics will arrive. And depending on the severity, it is possible that a doctor may also come after patient care has been handed over to paramedics,” Piyavka said in an interview. “No matter what happens, every time I call, when I get back to the fire department, I (send) the information to our computer database and there is an overdose code in there.”
Dean spoke about efforts in the Philadelphia area to coordinate aid across agencies.
“We have an area of the city known as Kensington where some of the worst cases of mental health, poverty and addiction are found,” she said, mentioning that she recently spoke with the Philadelphia-based Scheller Foundation about efforts to address the problem. overdose.
“So, literally what the[Scheller]foundation is doing is trying to bring together various hospital systems, non-profits, rehab centers and housing to solve this problem in a very coordinated way, not just one emergency room recovery. problem to another emergency room.”
Council of Deputies
The RAND report, which has been in preparation for several years, proposes a four-part framework that decision makers can use to develop effective policies for helping people with substance use disorders.
This four-pronged approach includes:
- Integration of problems and systems.
- We are trying new approaches.
- Designing roles for people who can “own” systems.
- Modernization of data systems for a better understanding of the problem.
The authors of the study created a searchable tool to encourage a “holistic approach” as policymakers weigh how to handle the opioid crisis.
“There is no silver bullet,” Stein said. “…People with an opioid use disorder move through so many parts of this ecosystem. But often one part of the system doesn’t have a very good idea of what’s going on in the other part of the system.”
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