Thursday, October 26, 2017 was a big deal in terms of confronting America’s opioid epidemic. President Donald J. Trump finally declared there is a public health emergency with the opioid epidemic, although he fell short of calling this a national emergency. Trump said, “We can be the generation that ends the opioid epidemic.”
When a public health emergency is issued, it expires in 90 days. Co-director of the Opioid Policy Research Collaboration at Brandeis University’s Heller school, Dr. Andrew Kolodny’s response was, “This is not a plan,” and found the announcement, “very disappointing.” The Public Health Emergency Fund, however, is practically empty and will remain depleted until Congress decides on a budget deal or during end-of-the-year budget negotiations.
On the same day, John Kapoor, was arrested on federal charges for bribing doctors to prescribe fentanyl. Kapoor, the billionaire founder of Insys Therapeutics Inc., resigned from the board of directors on Sunday. In January 2017, he removed himself as CEO of the company. He faces of charges of conspiracy to violate the Anti-Kickback law, conspiracy to commit mail and wire fraud, and RICO conspiracy. Insys manufactures Subsys, an under-the-tongue spray the FDA approved only for cancer patients containing fentanyl. In December 2016, the U.S. Attorney’s office in Massachusetts arrested and charged six former executives of Insys; recent charges against Kapoor stem from their indictment which was unsealed on Thursday. All seven allegedly conspired to seek fraudulent approval of Subsys prescription from insurance companies for non-cancer patients.
Last Thursday, the NYPD website reported New York City law enforcement departments including the U.S. Drug Enforcement Administration (DEA) New York Division and the Homeland Security Investigations (HSI) New York, reported the arrest of seven defendants indicted with sales of heroin and fentanyl to undercover officers combined with weapons charges. A fentanyl overdosed reversed by emergency responders led to an additional charge for one defendant.
The New York City Department of Health and Mental Hygiene reports a 46% spike in fatal overdoses from 2015 to 2016 (a record high of 1,374 deaths) directly because of fentanyl which is being mixed into illegal narcotics. Fentanyl is about 50 times stronger than heroin.
Bringing criminal charges to dealers (including pharmaceutical companies) can help put an end to the surge of opioid overdoses. In the meantime, we must stop criminalizing drug users. Communities, neighborhoods, and families can help change the treatment narrative where health and safety come first and not incarceration; public health prevention of overdose needs to be considered part of the treatment model and not a contradiction to the current abstinence-only system.
Barry Lessin, co-founder and President of Families for Sensible Drug Policy offers this: “Certainly, there are bad actors in the pharmaceutical and healthcare industries who are committing fraud (and worse) whose actions need to be interrupted and criminally sanctioned. But it’s dangerous and also misguided to lump these people in with street dealers, most of whom are friends and peers of users, who are dealing to support their addiction. Criminalizing them will NOT reduce the flow of drugs and will send more people who may need health care services into the criminal justice pipeline.”
This Thursday, in New York City, The New School for Social Research (along with the school’s Student Health Services) will hold a free and open to the public town hall meeting, “Celebrating Life: New Solutions for the Opioid Crisis,” where attendees will be trained in overdose prevention strategies and given naloxone kits.
Lessin explains how the town hall addresses supply reduction efforts work only when resources are spent on “proven public health DEMAND approaches that are grounded in harm reduction principles like: low threshold health care services (no imposed requirements), syringe exchange programs, supervised injection facilities (SIFs), and open access to MAT (bupe/methadone/naltrexone) for those who want it or need it.”
There will be a public policy discussion with experts from the Association of Substance Abuse Professionals; Center for Optimal Living; Families for Sensible Drug Policy; Coalition for Behavioral Health; New York City Department of Health and Mental Hygiene; New York State Psychological Association- Division on Addictions; and Voices of Community Activists and Leaders. This is exactly the kind of community involvement necessary to solve the opioid epidemic.
“Our families are in a unique position to directly influence the development or resolution of substance use problems and making these options readily available to us in our communities and home will allow us to offer the support and care we deserve,” says Lessin.
“Public health strategies to address the opioid and overdose crises such as overdose reversal with Naloxone and sterile syringe access help people stay alive and reduce the risks health risks associated with opioid use,” says Dr. Andrew Tatarsky, founder and director of the Center for Optimal Living. “In essence, the harm reduction framework offers relevant services to drug users where ever they are ready to begin their positive change process. People are engaged in respectful, collaborative harm reduction therapy relationships are all positive change motivations and goals.”
Communities working together to provide integrative harm reduction public health policies, such as overdose prevention training, as well as police cracking down on illegal fentanyl distribution, is how we can end this Public Health Emergency. Dr. Tatarsky adds, “These plans can draw on the full array of medical, psychological and social strategies to create integrated personalized and effective treatment.”
EVENT INFORMATION: Celebrating Life: New Solutions for the Opioid Crisis November 2, 2017 6:00 to 8:30 p.m. The New School for Social Research 63 Fifth Avenue, Hoerle Lecture Hall, UL105, New York, NY 10011