Indeed, an analysis
performed by the National Bureau of Economic Research (NBER) suggests that the issue may be one of competence, as opposed to criminality. The NBER assessment found that physicians educated at lower-ranking medical schools in the United States are roughly 30% more likely than their colleagues who are educated at the country’s top schools to improperly (though not necessarily illegally) write prescriptions for patients for opioids. Because American physicians wrote more than 2 billion prescriptions for opioids between 2006 and 2014 alone, these numbers are not insignificant.
Furthermore, as Contagion® reported
in June, a systemic review of 106 studies conducted by researchers at Johns Hopkins Bloomberg School of Public Health and the University of British Columbia found that criminalizing drug use had adverse effects on health outcomes in those with HIV related to injection drug use. The authors concluded that the joint stigmas surrounding HIV and illegal injection drug use, coupled with their fear of incarceration for drug-related offenses, prevented many of these patients from seeking, and thus receiving, proper treatment.
Conversely, as Amanda Binkley, PharmD, AAHIVP, Clinical Pharmacy Specialist-Infectious Diseases at the University of Pennsylvania Health System, wrote in an analysis
August 2017 print issue, multiple studies have indicated that behavioral interventions; substance abuse treatment, including opiate-replacement therapy; needle exchange programs; and the creation of affordable and accessible treatment programs have
been successful of reducing HCV transmission among people who inject drugs.
And, so, while it is positive that the president and his administration are speaking to the issue of opioid addiction in the United States, it remains to be seen what actions will result from their words. Declaring a state of emergency will free up federal disaster funds to implement new programs to respond to the crisis and allow for the waiving of certain rules and regulations to enable agencies to respond quicker.
But, will that response be care-focused or crime-focused? As with most government regulations, we will need to wait and see.
Brian P. Dunleavy is a medical writer and editor based in New York. His work has appeared in numerous healthcare-related publications. He is the former editor of Infectious Disease Special Edition.
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