“Collaboration at every level: Solving the country’s opioid crisis” is the recent posting by Mark Price, US Public Sector Leader, of the Deloitte Center for Health Care Solutions and Deloitte Consulting LLP.
In this compelling editorial, Mr. Price writes (with citations to credible sources) what we already know (but bears repeating):
The numbers are staggering. Drug overdose is now the leading cause of accidental death in the US, ahead of car accidents and suicide, and claimed 47,055 lives in 2014 alone.2 Six in 10 of these deaths involved some type of opioid, including both prescription drugs and heroin. To put this into perspective, since 2000, the rate of overdose deaths involving opioids has more than doubled; it grew from 6.2 deaths per 100,000 Americans in 2000 to 14.7 per 100,000 in 2014.3
But, it is more complicated than that. Three out of four Americans who are addicted to heroin were introduced to opioids through prescription drugs. This linkage adds to the complexity of the problem, as heroin use and opioid abuse impact different geographies, age groups, and genders, and deserve different approaches.
This problem has directly impacted organizations across the health care system as they struggle to manage the staggering costs. In 2012, the cost of inpatient hospitalizations related to opioid abuse reached $15 billion. This figure has nearly quadrupled since 2002.
For state government agencies, the first step is acknowledging that this is not a regional issue but rather a nationwide problem and should be a legislative priority in each state. States can play a role in increasing access to treatment options via public insurance programs, developing harm reduction strategies that include broader administration of Naloxone – the medication used to block the effects of opioids and prevent overdose – and investing in social programs that focus on prevention. States can also use their regulatory authority in the form of Medicaid demonstration waivers to tailor service delivery to meet their population’s treatment needs. The recent legislation in Massachusetts, for example, mandates a seven-day limit on opioids prescribed for the first time and also creates funding for addiction screening for both middle and high school students.
In Florida, our governor has rejected any form of Medicaid expansion, which funds could go towards community-based activities to thwart this problem from growing larger and larger. Meanwhile, we continue to import a disproportionate number of patients from across the country whose home states do not have the infrastructure in place to handle the demand.
While opening a residential detox program may seem like “good business,” it is a medically-necessary service to combat over-prescription of opioids. Outpatient detox programs also need to be accepted by local zoning authorities as necessary to treat those who may not be wholly “addicted” but yet still need services.
Overall, our community must come together to accept that South Florida can be and must be a center of addiction treatment excellence. We cannot “zone out” treatment providers unless and until it is determined that a quarantine of such persons is medically and scientifically required, which of course, is absurd.
Some people want to change the law so that cities may maintain home rule authority to deal with the opioid epidemic. That too is absurd. We need to start treating this problem “not a regional issue but rather a nationwide problem and should be a legislative priority in each state.”