Opioid overdose rates ‘impossible’ to ignore

Opioid overdose now kills more people than both AIDS and homicides in America and has surpassed automobile accidents as the leading cause of accidental death in many states. According to the Centers for Disease Control and Prevention, the burgeoning epidemic accounts for approximately 16,000 deaths per year in the U.S.

“No one was talking about this problem a few years ago,” said Leo Beletsky, a drug policy expert and assistant professor of law and health sciences at Northeastern University, “but it has now become impossible for public health and law enforcement officials to ignore.”

In an article published earlier this month in the Journal of the American Medical Association, Beletsky and physician-researchers Josiah Rich and Alexander Y. Walley called upon federal agencies to take leadership in addressing this epidemic through a comprehensive series of public health-based initiatives.

The trio of researchers posits that the federal government’s current response to the growing public health crisis has focused too narrowly on restricting access to prescription and street drugs, an approach that has failed to produce results. “We know from decades of experiences in substance abuse how difficult it is to win battles by focusing too narrowly on the ‘supply’ side of the equation,” Beletsky explained. “As things stand, not enough is being done to maximize the opportunity of saving lives.”

A litany of barriers has constrained the response, he said, including low public awareness of the signs of an overdose; a shortage of Naloxone, an opioid antagonist; and an unawareness or unwillingness on the part of prescribers to participate in overdose education.

Of the Naloxone shortage, Beletsky said, “Drugs like Naloxone that are cheap, generic and out of patent are more likely to be in shortage because they aren’t perceived as a priority for manufacturers.” He called attention to the issue in a recent Time Magazine article in which he was quoted.

In the paper, Beletsky and his colleagues make more than a dozen recommendations designed to improve the prevention of fatal opioid overdose. They call upon the National Institutes of Health to evaluate community-based naloxone access initiatives, for example, and for the Department of Justice to formulate and disseminate model legislation proving legal immunity to naloxone prescribers and lay responders. They also singled out the U.S. Food and Drug Administration, calling on the organization to require continuing education programs for healthcare providers to cover overdose prevention.

“Federal agencies and policy-makers can and should take concrete steps that could go a long way toward addressing this issue,” Beletsky said. “We have seen a lot of successful experimentation in overdose prevention on the local and state level and now it is time for the federal level to take the lead.”

View selected pub­li­ca­tions of Leo Beletsky in IRis, Northeastern’s dig­ital archive.