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July 08, 2020

Preventing the opioid epidemic from getting worse requires attacking it at the source

Credit: The Hill

Experts are predicting, and we are beginning to see, a significant uptick in opioid use disorder and overdoses as a result of the health and economic crisis caused by COVID-19. We know that stress and isolation are significant contributors to the onset of opioid use disorder, and we also know that the reduced access to substance use disorder and mental health treatment spurred by the pandemic will make this crisis worse.

Ending the addiction and opioid use disorder epidemic requires us to do more to take on this illness at the source. One way to do this is to curb the over-prescribing of opioid-based painkillers. While we have seen a decline over the past few years in the United States in opioid prescriptions, in 2018 doctors wrote over 168,000 prescriptions for opioid pain killers. Taking opioids for as few as five days can increase the risk of long-term use, and users of heroin often start by using prescription opioids. As the National Opioid Commission stated, “We have an enormous problem that is often not beginning on street corners; it is starting in doctor’s offices and hospitals in every state in our nation.”

The good news, however, is that there is a prevention measure that we know works – ensuring providers discuss with patients the potential of addiction and non-opioid alternatives before prescribing an opioid-based pain reliever. Currently 17 states have laws on the books requiring these conversations, which have shown to be an effective way to reduce the number of patients given a prescription for opioids without unduly restricting medication for those that need it. When the patient is a minor, this information is also provided to their parents in the room. This conversation with parents is especially important for minors who are prescribed opioids as a result of a sports injury or dental work.

A recent Brandeis University study of the law’s impact in New Jersey, the first state to implement the law, showed that the number of patients prescribed opioids for acute pain significantly decreased after the law went into effect. In the month after the law was implemented, nearly 5,000 fewer patients were given new prescriptions for opioids.

Additionally, there was a fourfold increase in the percentage of doctors warning patients of the risks of opioid addiction. Prior to enactment, only 18 percent of study participants warned patients about the risk of opioid addiction when prescribing opioids. After enactment, 95 percent routinely warned patients about the risk of addiction.

Before starting any prescription or treatment, it’s important for patients to understand the potential risks and benefits involved. Opioid pain relievers can be the best option for some people, but patients should at a minimum know their addictive potential and what alternatives exist. In Congress, I’m working to attack the opioid epidemic from every angle, including through prevention, and will work to ensure that everyone who receives a new prescription for an opioid understands the potential outcomes. This is a simple, but extremely effective step that we know saves lives.

At this critical moment, with a surge of substance use disorders and overdoses anticipated due to COVID-19, providing all American patients and parents with this life-saving information will be a strong step toward ending this epidemic, which already takes nearly 50,000 lives annually. We must act now.