Tuesday, July 19, 2011

Join Us in Exploring How Laws and Policies Can be Used to Address the Opioid Overdose Epidemic

By Leo Beletsky

Leo Beletsky is a lawyer and a longtime advocate for overdose prevention programs, and is currently with the Division of Global Public Health at the University of California, San Diego School of Medicine. This is the first in a series of articles on overdose law and policy that Leo will be spearheading here at OPA.

As others have pointed out on this blog, there is a growing recognition of the toll that overdose is taking on families and communities in the United States and around the globe. As the issue has started to become too large to ignore, governments' knee-jerk response has always harkened back to the same old “supply reduction” policy strategies, such as closing down clandestine labs, going after rogue doctors and ‘pill-mills,’ creating barriers to drug diversion from the pharmaceutical supply chains, and interrupting drug trafficking routes from abroad.

This approach is the cornerstone of the White House ONDCP Prescription Drug Abuse Prevention Plan published earlier this year.  Although “demand reduction” approaches such as public education about overdose risks figure among the report’s recommendations, the document does little to acknowledge that many of these well-worn promises of ever-stricter enforcement and requirements for educational outreach have continued to fail.  Even in the best-case scenario, many of the solutions offered by the White House would take years to implement and even longer to evaluate to determine their effectiveness.  

Is there an alternative way for laws and policies to be used to curb the overdose epidemic? Others on this blog have written about successful efforts that rely on trainings for drug users, their partners, and others to recognize heroin overdose and administer naloxone, the opioid antagonist.  In the IDU context, the programs have been successful, but they face a number of legal hurdles connected to the status of naloxone as a prescription drug and other legal barriers (see publications here and here). There are also legal questions, such as criminal consequences to witnesses calling for emergency help and administering naloxone without a medical license.  A number of US states (and localities) have taken steps to reduce these legal barriers through legislation.  However, this process has been difficult and slow; the legislation enacted has also been piecemeal and its impact has not been evaluated.  Other legislative proposals have been made, and some are moving through legislatures in the US and elsewhere in the world.

With more data about the rising tide of overdose deaths emerging every day, a growing number of governments are expressing interest in legislative interventions to address the overdose epidemic.  In this series on Using the Law to Curb Opioid Overdose, we will explore the various components of policy efforts that have been introduced to address the overdose epidemic, discuss the evidence of the effectiveness or the potential benefits and drawbacks of these “legal interventions,” and look at alternatives that offer more immediate results.   

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