On October 26, 2017, President Trump declared the Opioid Crisis a “public health emergency,” establishing a mechanism to devote considerable federal resources to help combat the growing opioid crisis, and setting in motion a coordinated approach by several federal agencies to focus on and eliminate this dire crisis.
Numerous public officials supported this effort, while some critics urged the President to include more funding to expand existing and to implement new treatment programs.
The depth of the crisis is real. In 2015, over 33,000 people in the U.S. died from an opioid overdose. As compared to 1999, the problem from opioid overdoses has increased by over 400%. The opioid crisis is rapidly overwhelming all aspects of our society, affecting all ages, races, ethnic backgrounds, and socioeconomic levels. Experts firmly believe the wave of opioid abuse has not yet crested. Unless society, including hospitals, substance abuse clinics, physicians, and other providers quickly and effectively confront the problem, opioid abuse is projected to increase and will have a devastating impact on local communities. Part of the problem lies in the severity of the addiction and the strength of the opioids being abused.
Hospitals, physicians, substance abuse clinics and other health care providers should be proactive, and adopt a multi-pronged approach to address the opioid public health emergency facing their communities, including taking the following steps:
- Form a task force or appoint a substance abuse director to study the issue and create recommendations to be adopted.
- Update and improve screening and treatment protocols to identify addiction problems.
- Thoroughly review existing prescribing practices to assure compliance with CDC prescribing guidelines, federal and state laws, and local medical board requirements, including prescription drug monitoring program (“PDMP”) practices and procedures. Included in this review should be a consideration as to whether the state and other payors are restricting prescriptions of opioids, and whether the providers should adopt strict guidelines regarding prescribing and treatment guidelines for opioid and other substance abuse problems.
- Educate professionals and staff regarding newly established guidelines and policies.
- Integrate with public education efforts to promote prompt effective treatment and responsible prescribing practices at the community level.
- Ensure physicians obtain any federal DATA-waiver and state licensure required to treat patients with office-based opioid treatments.
- Determine if it is appropriate and permitted to implement standing order prescriptions for Naloxone.
- Review and revise internal policies to reduce the potential for diversion of opioids within the health care setting.
- Review and revise policies regarding substances abuse testing and other related policies in the employment setting.
- Develop a comprehensive screening program for new professionals seeking privileges and for all hospital employees to avoid wrongful credentialing problems.
- Determine whether substance abuse services can be effectively delivered internally, by horizontal or vertical integration with other programs, or by partnering with substance abuse programs that have developed effective approaches to treatment; and develop a comprehensive referral network to address all levels of the substance abuse problem.
- Develop a comprehensive reporting scheme to report issues associated with substance abuse to regulatory and licensing agencies, as may be required by law.
Task forces and substance abuse directors addressing the opioid crisis should be well- informed as to the programs established by the President’s Commission on Opioid Abuse, the CDC, the Drug Enforcement Administration, local boards of medicine, and state agencies, as many of these programs have developed their own comprehensive approach and regulatory framework to combat opioid abuse. In addition to the foregoing, increased emphasis will be placed upon enforcement of federal and state laws to address the opioid crisis including but not limited to:
- The Helping Families and Mental Health Crisis Act of 2016.
- The 21st Century Cures Act of 2016.
- Increased enforcement of the Mental Health Parity and Addiction Equity Act of 2008.