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Report: States missing the mark on protecting public from opioid overdose

June 30, 2016
by Gary A. Enos. Contributing Editor
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Most states are falling considerably short in protecting their residents from potentially deadly prescription opioid overdoses, especially in the area of broadening access to opioid use disorder treatment, states a National Safety Council (NSC) report released last week. Only four states (Kentucky, New Mexico, Tennessee and Vermont) meet five of the NSC's six key indicators of progress in combating the opioid crisis, according to the report.

On the other end of the spectrum, three states (Michigan, Missouri and Nebraska) meet none of the council's six indicators, states the report, Prescription Nation 2016.

“Multiple actions will be needed to end this drug epidemic and reduce the loss of life,” the report states. The report follows an NSC analysis that found that an increase in preventable deaths to an all-time high is largely attributable to opioid overdose.

Among the indicators measured in its latest report, the NSC noted that just 12 states meet its standard for eliminating “pill mill” operations by enacting laws to regulate pain management services and only 17 states require prescribers of controlled substances to receive continuing medical education (CME).

Most states have met between one and four of the six indicators, according to the NSC. Six states and the District of Columbia have met one indicator, 18 have met two, 10 have met three and 9 have met four.

Magnitude of crisis

The introductory sections of the report describe the opioid epidemic as “the deadliest drug crisis on record,” adding that much of the public still underestimates its magnitude. The report cites a 2015 NSC opinion poll in which nearly 90% of opioid users said they were not worried about addiction, even though 60% said they had an addiction risk factor, such as a family history of alcoholism or a personal history of physical, mental or sexual abuse.

The report concludes with 11 recommendations tied to the six indicators of progress. The final four recommendations center on medication-assisted treatment, and include increasing patient caseload caps for physicians authorized to prescribe buprenorphine, as well as allowing advanced-practice nurses to receive buprenorphine prescribing authority.

The report assesses the issue of supply of methadone and buprenorphine treatment by stating, “With most state [opioid treatment programs] operating at capacity, buprenorphine, which can be prescribed in office-based settings, offers the most viable way to expand access for MAT.”