The United States is undergoing the most fatal drug overdose epidemic in our history. A multi-pronged approach to tackle the epidemic is required. Dan Meuser supports President Trump’s declaration of the opioid epidemic as a national public health emergency, but believes we must do much more.
The supply of prescription opioids in Pennsylvania alone is astronomical. In 2016, there were 475 million opioids prescribed, which translates to a staggering 37 pills per person.* In Mount Carmel, reports indicate one doctor operated a “pill mill,” prescribing 2,792,490 doses of opioids in a 19-month period.
These are outrageous, obscene amounts of opioids flooding our communities—quantities that should have been both detected and prevented.
There are three broad areas that must be addressed: 1) supply; 2) harm reduction; and 3) recovery:
SUPPLY
Increase Standards for Prescriptions of Opioids
Some states have laid out recommendations for limiting the amount of supply, as did the Centers for Disease Control (CDC), but while such recommendations can help, that alone is not enough. Product manufacturers and the medical community must bear greater responsibility in being part of the solution to this epidemic. The quantities administered to patients are too plentiful too often; larger quantities should be the exception, not the rule. We do not suggest innocent people who suffer from chronic pain due to serious medical conditions (e.g., cancer patients) are denied medication—they need support and understanding--however, we must recognize that there are instances where certain other patients are overprescribed quantities and/or too quickly given opioids when other medications could be utilized. The market supply of opioids must be controlled. We must employ methods of monitoring volumes prescribed by physicians.
There needs be more intensive training emphasizing the gravity of opioid addiction and reducing the misuse, abuse and circulation of these drugs.
Prevent Illegal Influx & Internet Purchase Accessibility
Access to fentanyl and other synthetic opioid derivatives must be curbed immediately via international and local law enforcement interdiction efforts.
We need to control the influx of product purchased on the internet’s “dark web”—deadly, often China-based, fentanyl products are coming into this country and monitoring and preventing these transactions must be part of our nation’s law enforcement and cyber-security strategy.
Internet pill press machines are affordable and accessible on the open net as well—one press alone can produce 5,000 pills/hour and purchase of such machines should be both monitored and heavily controlled.
Further enforcement along the US-Mexico border is essential to curtail the tide of opioid derivatives, including heroin, from entering the United States. We must invest in improved narcotic detectors /technology at ports of entry. It is imperative that we secure the border to prevent smugglers and illegal immigrants from bringing drugs into our country.
Importantly, the consequences leveled upon those who traffic such products into our nation must be devastating. Severe penalties must be fall upon those trafficking fentanyl, fentanyl-laced opioids and heroin.
Support Law Enforcement
Our first responders, often operating with diminished personnel in our communities, are stretched to full capacity and beyond due to this epidemic. They need to have the tools necessary to deal with this epidemic. Law enforcement needs the financial ability to access life-saving products (e.g., Narcon Kits) that quickly halt the deadly effects of opioids. They also require training so they know how to properly administer such products. We must also improve the process of “soft handoffs” so that our first responders who take overdose victims to hospitals can be assured the hospital is immediately coordinating patient entry into rehabilitation facilities, rather than release. And law enforcement, homeland security and our intelligence community must all be provided the support needed to fight trafficking both at the border and over the internet.
HARM REDUCTION
We must encourage medication drop off programs in our communities so that old/unused prescriptions are no longer easily accessible simply by reaching into a household medicine cabinet. Such drop off programs can range from having pharmaceutical locations take back prescriptions and/or vehicles monitored by police (e.g. drug drop off vans) that are available in communities for medications to easily be dropped off.
We must continue to implement electronic databases for monitoring opioid prescriptions written by the medical community in order to prevent excessive prescriptions by doctors (to prevent “pill mills”/excessive dosages, but while maintaining patient privacy and adhering to HIPPA Laws).
We need to support the growing need to develop programs in our communities for those working through the ongoing, long-term process of recovery (family assistance, employment, child care) in order to help ensure success.
Education
There needs to be an ongoing investment in and commitment to expanding education in our communities via advertising and grassroots campaigns to generate awareness regarding the dangers of opioids and also in our schools and healthcare facilities. Cooperating with law enforcement on the local level, we need to get ahead of the problem by deterring usage in the first place.
RECOVERY
We cannot simply arrest our way out of this drug epidemic. We need to coordinate our efforts to help non-violent drug offenders rehabilitate and re-assimilate as productive members of society. We also must pursue funding for recovery access to help people who are addicted to opioids.
Improve Access To Rehabilitation
There has been tremendous success with community-based rehabilitation centers, and we must continue to learn from and build upon this success and facilitate the access to, insurance for, and affordability of rehabilitation for people struggling with prescription opioid and/or heroin addiction.
There have been many success stories of medication-assisted treatment (e,g., methadone and buprenorphine) and we need to use the programs that work effectively as models.
And drug courts that are having strong success rates with offenders assimilating back into society productively must be studied and utilized across our Commonwealth and our nation.
*Thank you to all members of law enforcement who met with our campaign over these many months to provide their expertise and recommendations. A particular note of thanks to Berwick Police Chief Ken Strish, for sharing with our campaign national, statewide and local data and suggestions from the Police Assisted Addiction & Recovery Initiative (PAARI). We reserve the right to amend ongoing as additional findings, methods and treatment options become available ongoing.
