WashU Expert: Opioid emergency needs science-based solutions

President Donald Trump declaring the opioid epidemic a national emergency is an important statement and first step toward admitting a problem, said an expert on opioid addiction at Washington University in St. Louis, while warning that without science-informed solutions and plans of action, the epidemic will worsen.

The nation has seen three drug epidemics, said David Patterson Silver Wolf, associate professor at the Brown School and an expert on substance use disorder treatment services.

Patterson

“The first was a heroin epidemic during the closing years of the Vietnam War,” he said. “The death rate during that epidemic was about 1 per 100,000 people. Our second occurred in the early 1980s during the crack epidemic. The death rate during this epidemic was about 2 per 100,000. Our current opioid overdose epidemic’s death rate is about 10 per 100,000.”

Over 52,000 Americans died in 2015, Patterson said.

“In 2016, it is likely that 65,000 people died from an opioid overdose,” he said. “Today, about 100 Americans will die as the direct result of this epidemic. The daily rate of deaths in the U.S. is likely to continue increasing with virtually no end in sight.”

Why?

“The path for individuals to develop an opioid use disorder is very easy to travel,” Patterson said. “The path for individuals to obtain treatment for an opioid use disorder is laden with perilous obstacles and barriers.”

“Throughout our country, we can still walk into most health-care systems and on that same day, leave with a prescription for opioids. According to the U.S. Health and Human Services Administration, every day more than 650,000 opioid prescriptions are dispensed in America. The initiation period toward an opioid addiction is swift and fatal,” he said.

Unfortunately, Patterson said, if an American is interested in seeking some level of substance use disorder treatment, they most likely will experience a long wait period and, if they survive and maintain their place on the list, they will encounter a system that is underfunded, understaffed and overburdened.

“If we are to solve this national emergency, these two paths have to switch,” Patterson said. “Our health-care systems should prescribe opioids in a restrictive manner similar to how morphine is administered throughout our country. Opioids should only be available to Americans inside the walls of a hospital, under supervised care, followed by medical detox before discharge. With the Center for Disease Control and Prevention (CDC) recommending that opioids be prescribed no more than three days, any pain lasting longer than this short period can be treated with over-the-counter, non-addicting medications.”

The switch also would require that substance use disorder treatment systems be funded and supported in relation to this national emergency, he said.

“We should be concentrating on increasing our health-care workforce, as well as access to treatment,” Patterson said. “Individuals who are in crisis should get same-day treatment.”

“To seriously solve this crisis, we have to block the easy path toward developing an opioid use disorder and remove the barriers to professionally treating this illness by increasing the resources on the ground,” he said.

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