Sunday, July 16, 2017

On the Opioid Epidemic in the United States

  • Last week, comments in the report “Pain Management and the Opioid Epidemic” from the National Academy of Sciences included:  “Rates of opioid use disorder and opioid overdose deaths have reached unprecedented levels over the past two decades, and have risen much faster in the United States than in most other countries …  
  • U.S. Department of Health and Human Services data suggest that at least 2 million Americans have an opioid use disorder involving prescribed opioids and nearly 600,000 have an opioid use disorder involving heroin ...
  • about 90 Americans dying every day from overdoses that involve an opioid … 
  • the professional societies, insurers, health care organizations, pharmaceutical manufacturers, and state and federal agencies collectively responsible for shaping prescribing practices should attend to the multiple weaknesses in the nation’s health system that led to this epidemic …  
  • Trends indicate that premature deaths associated with the use of opioids are likely to climb and that opioid overdose and other opioid related harms will dramatically reduce quality of life for many people for years to come … 
  • Years of sustained and coordinated effort will be required to contain the current opioid epidemic and ameliorate its harmful effects on society."
  • Note: The chart below presents the number of overdose deaths from prescription and illicit opioids in the United States from 1999-2015

  • Separately, Federal Reserve Chair Janet Yellen (during testimony to U.S. Senate) said there are  “a variety of adverse trends related particularly to technological change that has eliminated many middle income jobs … 
  • I do think [the opioid epidemic] is related to declining labor force participation among prime-age workers … 
  • I don’t know if it’s causal or if it’s a symptom of long-running economic maladies that have affected these communities and particularly affected workers who have seen their job opportunities decline.” 

MY TAKE

  • While law enforcement efforts will likely be highlighted as a way to address the opioid crisis, the challenge is broad and will also require assistance from insurershealth care organizations, government agencies, pharmaceutical firms and educators.
  • contributing factor to the problem is that the U.S. (unlike many other countries) allows aggressive marketing by pharmaceutical companies - which includes prescription opioids.
  • Regarding Yellen's comments - as technological change reduced the number of good paying jobs,  it may turn out to be another contributing factor to the opioid epidemic. 

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