It's Time To Go Further to End the Opioid Crisis

(AP Photo/Rick Bowmer)

Syringes of the opioid painkiller fentanyl are shown in the inpatient pharmacy at the University of Utah Hospital in Salt Lake City.

Shortly after the Centers for Disease Control issued the sobering news that an estimated 72,000 Americans died of drug overdoses last year—the most ever—the Senate passed the Opioid Crisis Response Act of 2018. Approved with bipartisan support on September 17, the bill takes reasonable measures to combat the over-prescription of opioid painkillers and slow the flow of illicit drugs, such as the hyper-lethal fentanyl, entering the country.

The measure includes improved detection and testing technology at the border; grants for comprehensive treatment recovery centers in the hardest-hit communities; first-responder training; and support services for children and families affected by the crisis.

But the legislation also has vague language about setting more stringent requirements for manufacturers and distributors, including a provision allowing the Food and Drug Administration to require drug makers to package smaller quantities of controlled substances like opioids, and initiatives to educate and raise awareness about proper pain treatment among health-care providers. And given Washington’s coziness with Big Pharma, these provisions are unlikely to have much of an impact.

Many public health officials fear the bill does not go far enough. Departing Health Commissioner Dr. Leana Wen of hard-hit Baltimore (who was recently named to head Planned Parenthood) said the legislation “is simply tinkering around the edges” of this unprecedented crisis, one that is slaughtering Americans at higher rates than peak annual death totals from HIV, car crashes, or guns.

These critics have a point. For example, a breakdown of 2017 death totals shows that the spike in deaths is almost entirely attributable to fentanyl, a synthetic opioid some 50 times more powerful than heroin. Nearly 30,000 deaths involved synthetic opioids like fentanyl—almost as many as heroin and conventional opioid painkillers combined.

What’s happening is scary: Street drugs like heroin and cocaine are being cut with a synthetic superdrug that saves drug dealers money while killing unsuspecting users.

These are the hate crimes of drug offenses, taking tens of thousands of lives. Stronger criminal penalties including life imprisonment need to be considered.

Opioid abuse is an emergency and lawmakers need to treat it like one. And if they won’t, we the people should through the most expedient avenue available: the courts. Indeed, another way to help ease the crisis is to hit back against the corporate profiteers. Many cities and states have done exactly that and, in August, President Trump threatened legal action against Big Pharma. Last year, in a Newsday op-ed, I applauded these ongoing efforts to persistently sue pharmaceutical manufacturers over their role in the opioid epidemic.

Escalating legal pressures on drug manufacturers is justified and sensible, and can work in tandem with other strong measures. The epidemic has made headlines long enough for doctors to be fully aware of the widespread abuses and for them to revamp their prescribing habits accordingly. Despite some promising progress, too many doctors still stand to profit as they freely dole out dangerous, potentially addictive opioid painkillers.

Lawsuits like the ones that hit the tobacco industry are sometimes more effective than laws. The goal is to make life difficult enough for over-prescribing doctors that they either stop giving “heroin for headaches” or stop practicing medicine altogether. Though it’s true that lawsuits can move at a snail’s pace, headline-grabbing lawsuits can move public opinion and effect change.

And like doctors, pharmacies must fill opioid prescriptions carefully. Earlier this year, Walmart and Sam’s Club took a noble stand against both abuses by patients and over-prescribing doctors by limiting patients to a seven-day supply of a prescription opioid. By 2020, the two chains will require e-prescriptions for controlled substances, making it harder to “pharmacy hop.” Both practices are worth emulating everywhere—and fast. So pass laws, yes, but the courts can also force change where legislation falls short: Bad publicity can change protocols and save lives. 

The anger over how this drug crisis has been handled compared with the racially-biased war on drugs in the 1980s, and with the ill-fated mandatory sentencing laws that have led to America incarcerating more people than any other nation, is certainly valid. But dealing with the crisis in the here and now is a public safety issue, not a political or polemical one. This is a four-alarm fire that requires a fast, firm response.

For once, Trump’s tough-guy routine could be put to good use to encourage legal action against irresponsible drug manufacturers and distributors while pressuring Congress to classify fentanyl as the killer that it is. Considering the incredible potency of fentanyl and the obliviousness of users, the trafficking of fentanyl is murder—and it’s time that it is treated as such. If Congress won’t act, Trump should simply go over their heads via an executive order. The urgent threat to public safety certainly warrants it.

The time for half-measures is behind us: 72,000 people per year equals about 200 people every day. Our sons and daughters are dying, the clock is ticking, and the steps that need to be taken are clear.

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