How Best Can We Handle the Opioid Crisis?

Addiction to the use of opioids is a major public health issue in the United States. The country has recently seen the use of opioid, as a medical intervention, degenerate into a drug-abusing craze, plunging the country into a health crisis never witnessed in US' history (Kolodny et al.560). Statistical evidence suggests that more than 155 Americans die every day from opioid overdose, more than the number of people dying from HIV/AIDS or car accidents. The deaths majorly result from misuse and addiction to opioid forms such as pain relievers, heroin, and fentanyl. Opioid abuse costs the United States $78.5 billion annually, creating a huge economic and social burden on the country (Lopez vox.com; NIDA drugabuse.gov).

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So, how did we get here? The current crisis started in the late 1990s when the pharmaceutical companies assured the medical community that opioid-laced drugs such as Oxcycontin cannot be addictive if used as pain relievers. Due to the widespread use, overdependence, abuse, and addiction have created the crisis (Davis; NIDA drugabuse.gov). For instance, walking through the back streets of Cincinnati, one encounters a community struggling to cope with the consequences of addiction; deaths, despair, addicts, broken family set-ups are a common sight (Cincinnati.com). Although efforts have been made to address the addiction crisis, it is clear from the recent declaration of the Trump administration that efforts are not directed to the right targets. The current crisis can best be resolved by increasing funding to healthcare organizations, amending extant laws and policies, mitigation of the factors motivating people into drug abuse, and reduction of the risk of death for the addicted populations.

Since the inadequacy of funds is a major hindrance against efforts to combat the opioid crisis (Lopez), increasing funding to health institutions can significantly reduce the cases of addiction and death related to the use opioids. In March 2018, the Trump administration allocated $3.3 billion to deal with the problem of drug abuse. The money will be used for various programs relating to opioid control, including treatment, research, and surveillance, among others (Lopez). However, Lopez and Davis indicate that experts view the allocation as far too little to tackle the problem of addiction effectively. As reported in the previous paragraphs, the deaths resulting from opioid abuse have outstripped the number of deaths reported regarding HIV/AIDs in the country every year. This implies that more money is required to address the crisis than the current budget for HIV/AIDs prevention and control which stands at $ 32 billion. Thus, substantial allocations need to be made to the anti-opioid abuse efforts for any meaningful positive outcomes to be felt on the ground.

Revising regulations regarding the conditions under which doctors can prescribe painkillers to patients can go a long way in addressing the problem of addiction among the US populations. Over the recent past, policies tightening the freedom of the doctors in prescribing painkillers have been formulated with a view of restricting the frequency of patients taking opioid drugs. The tougher rules are based on the policymakers' view that physicians have become rogue and, therefore, do not care about the addictive consequences constant uptake of painkillers has on the patients (Lopez; Singer cato.org). According to Lopez (vox.com), these policies are misguided in the sense that they limit the doctor's ability to offer the right prescriptions to their patients. When doctors are restrained from offering patients the right prescriptions, the patients' bodies may react in such a manner that worsens the addiction. In many cases, these patients resort to unregulated access to drugs which further exacerbates the problem. Thus, relaxing the surveillance laws would ensure that patients get the right prescriptions in the right quantitative thereby reducing the chances of addiction and overdose.

Relaxing laws on production quotas for pharmaceutical companies dealing with the addictive drugs can also play a big part in mitigating the opioid crisis. Since pharmaceutical companies assured health care providers that drugs such as Oxcycontin cannot be addictive but results of patient reactions suggested otherwise, the regulatory agencies have pushed for the enactment of laws that reduce of the drugs released into the market. The United States Drug Enforcement Administration (DEA), for instance, ordered a 25 percent decrease in opioid drugs production for 2017 and a 20 percent for 2018(Singer cato.org). The reduction directives are anchored on the notion that a reduction in supply would reduce use and hence a reduction in abuse and overdose cases. This expectation may not materialize because the demand for addictive drugs cannot be shrunk by straining the supply. Given this reality, it is critical that the quotas on supply be relaxed to avoid situations where heroin from the black market flood into neighborhoods and inner cities to meet the demand. Under such an environment, more Americans are likely to be addictive and more are likely to die from overdoses.

Banning the use of Fentanyl in the US, while controlling the distribution of other painkillers, has the potential to resolve the crisis. Fentanyl is a drug routinely administered in the outpatient setting and widely used for nonmedical purposes (Singer cato.org). This makes the drug more prone to abuse by users and contributes greatly to the addictive effect of the drug on the population. Quoting the National Center for Health Statistics, Singer observes that, of the 64,000 drug overdose deaths that occurred in 2016, 20, 000 were related to the use of Fentanyl, making the drug the leading contributor in overdose deaths. The author further notes that death rates from Fentanyl rose by 18 percent increase 1999-2013 to 88 percent from 2013-2016. The huge increase witnessed between 2013 and 2016 can be attributed to enormous imports of the drug from China (Niiler). Based on the above data, it is evident that banning can reduce the impact of the drug. For instance, it would increase addicts' access to alternatives domestically as researchers continue to develop with better substitutes.

At the same time, increasing collaboration with the Chinese authorities may reduce the amount of illegal Fentanyl entering North America. The bulk of the drug is imported from China. The Chinese drug is laced with high amounts of heroin, rendering it extremely addictive. This is due to illegal factories spread across China manufacturing the drug and illegally transporting to the United States. Despite the efforts made by the Chinese authorities to clamp down on the illegal factories, the business continues to flourish for the smugglers and the US continues to suffer (Niiler). For these reasons, the Trump administration needs to consider China as an important ally in solving this crisis. The recent imposition of trade tariffs on Chinese goods needs to be reexamined to create a friendly bilateral environment where the two countries can engage constructively in tackling the problem of illegal production of Fentanyl.

Besides the legal interventions, it is critical to address socioeconomic factors that predispose people to drug abuse and drug addiction. Addressing poverty and social isolation can be instrumental in alleviating the conditions that motivate people to abuse drugs. Living in poverty presents several limitations to the individuals affected. Poverty denies the basic material things that are essential for comfort. Living in poor environments can limit one's ability to access educational opportunities (Patrick, et al. 772-73; Valdez et al. 595).Since education is one of the common avenues through which people escape poverty, those who lack it often find themselves in a cycle of poverty which strains the physically and emotionally. Evidence from the study of Valdez et al. indicate that such deprivation can predispose the affected families to drug abuse and crime (595). Considering these outcomes, strengthening welfare system can mitigate the emotional strain related to low-income life.

Creating an environment for emotional attachment has been found to improve people's emotional stability. Significant drug abuse cases have been reported among rich income families. Research links the heavy drug use of illegal drugs among high-income families to the inadequate emotional attachment which leads to mental problems such as anxiety, depression, and other psychological disorders (Patrick, et al. 772). Due to the psychological instability, providing rehabilitation to the affected individuals and empowering them to participate in community activities can motivate them to open up on the various challenges they face in life. This would create the opportunity for support services such as counseling which could, in turn, assist victims to deal with negative effects of social isolation.

Giving medical-assisted treatment to drug abusers has been proposed as an effective method of mitigating the problem of heroin use in some countries. Although medical-assisted treatment involves continued use of drugs, it addicts to develop safer habits of using such drugs (Lopez). For example, medications such as methadone and buprenorphine can eliminate opioid cravings and the enormity of withdrawal symptoms among heroin users. This treatment can reduce the death rate among opioid addiction patients by at least half (NIDA drugabuse.gov). The highlighted approach can be useful in reducing cases of deaths related to overdose.

Perhaps the most practical approach to fight the opioid crisis is to provide the drugs but in less dangerous quantities. The US populations have become so dependent on the use of heroin that no eradication effort can entirely eliminate its use in the country. Regardless of whether legal, social, and political barriers are erected against the sale and use of addictive drugs, some people would use heroin not matter the circumstances. The goal of this technique is to limit the harm caused as a result of using heroin and not preventing people from using it (Lopez vox.com). According to Lopez, the strategy has been proved effective in countries such as the UK, Germany, Spain Switzerland, and the Netherlands. For example, the research done in the UK by Strang et al found that employing supervised injectable heroin (SIH) as a treatment mechanism resulted in better outcomes than the standardized treatment mechanisms. Since the use of SIH has been in place in England for years and results indicate superior performance, it can be implemented to offer addicts safer alternatives. Safer access would reduce street heroin which has contributed significantly to the current crisis.

Some consider providing drugs to the addicts as controversial. For them, including the Trump administration, eliminating the use of heroin can be achieved through increased surveillance on transportation and use of heroin and treatment of heroin addicts (Davis). However, the reality on the ground depicts a picture that can never be escaped; heroin use among Americans will not stop in the foreseeable future. Today, fentanyl, which is laced with fatal amounts of heroin, is manufactured in large quantities in China's black market and shipped to labs in Mexico where it is conveniently smuggled into the United States. Due to the widespread use of the internet in e-commerce, consumers can order heroin online from China and delivery is done at their doorsteps (Niiler). How can authorities manage to break this intricate chain of trade? By all accounts, it is impossible. So, a program that provides a safer form of heroin can reduce the amount of dirt heroin in the streets thereby encouraging safer consumption. As a result, deaths and cost of treatment of overdose...