As the United States battled the covid-19 pandemic, it was lost in the fact that the country suffered a record number of drug-related overdose deaths in 2020; about 93,000. In addition, from May 2020 to April 2021, the figure increased to 100,000. In addition, initial knowledge from the Centers for Disease Control and Prevention (CDC) estimates that more than 107,000 people died from drug overdoses in 2021, with 75% of deaths involving an opioid. Illicit fentanyl is the main culprit.
While the federal government spends billions looking for other sources and calls for secondary methods to combat the problem, it is the eighth bullet when it comes to this growing crisis. Similarly, state and local governments are not doing enough.
Over the past 10 years, where local, state and federal governments have acted in concert, there appears to be a disproportionate concentration on legal prescription opioids, which in many tactics are less difficult than illegal opioids.
However, it is vital to distinguish obviously between the role of prescription and illicit opioids in the existing opioid crisis. Contrary to public perception, the challenge of misuse, abuse and diversion of prescription opioids has been much less in recent years than that of illicit opioids. The symbol on a bottle of prescription painkillers accompanies articles about drug overdose deaths, creating the wrong impression.
Shortly after the prescription opioid prescription spike in 2012, about one-third of the 44,000 overdose deaths reported in 2013 were attributable to misplaced prescription opioid use. Since 2013, the percentage of drug overdose deaths that can use prescription opioids has declined, in part because fewer people are prescribed. Prescription discounts were based on more restrictive regulatory policies instituted in individual states and counties, and reinforced through the recommendations of CDC’s 2016 federal guidelines.
Some experts have warned that a series of undue restrictions have also swinged the pendulum in the direction of severely restricting prescription opioids, or even imposing a minimum, because those drugs have valid uses for some other people with acute and chronic pain.
There appears to be a correlation between moving to draconian opioid prescribing limits and expanding the use of illegal opioids. Of course, correlation is not causation. However, it is clear that illicit heroin and artificial fentanyl now account for the vast majority of drug overdose deaths, with fentanyl being the main driver.
Federal Government Efforts to Halt Procurement
The federal government of the EE. UU. se has focused on preventing the source of illicit opioids. Successive administrations have pursued policies for the illegal importation of these substances.
Most illicit fentanyl in the United States is smuggled from Mexico. Even fentanyl from China is diverted through Mexico.
The Obama, Trump and Biden administrations have raised the number of Border Patrol agents to more than 20,000. However, smuggling continues; Primarily through official ports of access smuggled by U. S. citizens along the border.
And, while the federal government has also provided truly extensive counternarcotics assistance (resources and manpower) to countries like Colombia and Mexico, the effects have been minimal at best.
Demand-side initiatives
While attempting to cut off the source is a logical step in addressing the problem, the good fortune of such policies has been extremely limited.
The challenge is that the federal government has recently identified that much of the challenge is in the call.
According to Dr. Rahul Gupta, director of the White House Office of National Drug Control Policy, only about 10 percent of people in the United States who want addiction care get treatment.
The news is that federal, state and local governments have focused on prevention and treatment.
The continued expansion of the Affordable Care Act under the Biden administration, for example, has been instrumental in making public fitness resources available and instrumental in addressing substance use disorders, especially for Medicaid recipients.
Biden’s administration has also eased restrictions on the use of buprenorphine, a drug used in particular for opioid use disorder.
Moreover, in October 2021, without much fanfare, Biden’s management proposed a new set of policies to halt the rise in drug overdose deaths. using illicit drugs; For example, a wider distribution of fentanyl control strips, which help users avoid illicit drugs infected with the lethal artificial opioid.
More controversially, the Biden administration’s plan includes expanding needle exchange programs, which for decades have proven effective in reducing the number of communicable diseases such as HIV and hepatitis.
At the municipal level, there is a slow advent of harm relief systems for illicit drug users. New York City legalized the creation of two supervised injection sites for drug addicts in Manhattan. The facility will supply blank needles and administer medications, such as naloxone. , to opposite overdoses. At the same time, users are presented with other drug remedy options.
Other municipal and local governments, particularly on the West Coast of the United States, have introduced large-scale systems aimed at restricting HIV transmission and overdoses by promoting safer drug use.
However, in general, the U. S. reactionIt is insufficient and disproportionate to the enormity of the problem. The Biden administration has invested more than $5 billion to create access to intellectual fitness care and to save it and treat opioid addiction. While this turns out to be an abundant amount of money, it is insignificant. The federal government has spent more than $18 billion on Operation Warp Speed to expand Covid-19 vaccines, with tens of billions more purchasing Covid-19 tests, vaccines, and treatments. In the United States, the national response to HIV has reached more than $28 billion annually. There is not the same kind of investment when it comes to the opioid crisis, or even the government’s willingness to tackle the problem systematically.
Observers say the federal government is not offering enough sustained investment to address the crisis. In addition, state Medicaid systems vary widely in their policy of recovery facilities and pharmaceutical interventions.
Recently, shortages of beds and resources for psychiatric patients, many of whom suffer from substance use disorders, have accelerated in each and every state, leading to severe hospital bottlenecks and very long wait times for admission.
Even relatively undeniable answers are not pursued as far as possible. For example, naloxone, which can counteract an opioid overdose, is still not as widely found as it deserves. Although naloxone is available without a prescription in all 50 states, it is not officially an over-the-counter product. The ability to purchase over-the-counter naloxone does not apply to organizations that purchase naloxone in bulk from drug brands. States do not have the authority to designate naloxone as an over-the-counter product. The federal government can do that. The Food and Drug Administration says no because drug brands begin the transition from prescription to over-the-counter status. While this is usually the direction for replacements, there is precedent for the FDA to step in and authorize a replacement. without the consent of drug brands.
In addition to the aforementioned disorders, there have been poor public health messages and a general lack of public education. Experts say federal, state and local governments deserve to devote far more resources to educating the public about the dangers of illicit opioids and the availability of medicine and other facilities. It’s not hard to find evidence of poor public messages about fitness. The few facilities presented are operated only by a very small minority of patients with substance use disorders.
Maybe the classes can be learned by enjoying themselves abroad. Twenty years ago, Portugal pursued a systemic national drug harm relief policy that decriminalizes possession of drugs for non-public use and focuses on remedy (adopting a plethora of characteristics tailored to patients’ individual wishes) rather than incarceration. In 2018, Portugal had the lowest rate of drug-related deaths in Europe.
In the 1990s, the Netherlands began providing bulk heroin to addicts as part of professionally supervised recovery services. The rate of high-risk or “problematic” use halved between 2002 and about fourteen thousand cases in 2012, according to the European Observatory. of Drugs and Drug Addiction.
Of course, there is no panacea that magically solves the fentanyl disaster or the abuse of other illicit drugs. And foreign efforts to address the opioid crisis don’t necessarily translate into the U. S. context. inadequate budgets allocated to the problem, chronic shortages and the limited scope of systems that exist, that much more can be done in the United States.