The Opioid Crisis Has Shifted — So Must Our Policy Responses

Recent news has shown us that while we have made progress in combating the opioid crisis, we still have a way to go.

Preliminary data from the Centers for Disease Control and Prevention has found that for the first time since 1990, drug overdose deaths have declined. While this is good news on the surface, the underlying data shows that there are still serious problems that policymakers in Washington need to confront.

Deaths involving prescription opioids are on the decline, and those involving heroin have leveled off. Meanwhile, fentanyl overdose fatalities continue to surge, indicating that the dimensions of the opioid crisis have shifted, and there is a new drug that must be confronted.

Fentanyl is a particularly powerful synthetic opioid. Up to 100 times more potent than heroin, it is increasingly popping up in a variety of forms on the street, most times unbeknownst to the addicts using these illegal drugs. The drug is often pressed into counterfeit pills to mimic increasingly difficult-to-obtain, legitimate pharmaceutical opiates or used to lace heroin or any number of other drugs in order to pad the profits of drug dealers and provide users with a stronger high.

Given that the smallest amount of fentanyl — 2 milligrams — is enough to prove fatal, it is not difficult to fathom why this drug is now the driver of drug-related deaths. In 2018 alone, fentanyl was responsible for 31,897 overdoses — or over two-thirds — of all opioid-related deaths. Illicit manufacturing operations and laboratories simply lack the sophisticated equipment necessary to operate within this microscopic margin of error, and addicts are now paying the price.

Newly released data from the Society of Actuaries demonstrates just how deep the opioid crisis runs. Over a four-year period from 2015-18, it calculated the total economic cost of the opioid crisis at $631 billion. Dig deeper and you’ll find that families are often bearing the brunt of this addiction crisis.

Social service programs are stretched thin. During that same four-year time frame, an additional $39 billion was spent on child and family assistance programs and education programs. 

Every 15 minutes, a baby is born suffering from opioid withdrawal, a condition that results in costly hospital stays. CBS News reported that the opioid crisis is forcing more kids into the foster system, requiring the state or other family members to assume the child-raising responsibilities of drug-addicted parents.

There is no doubt that the financial and human costs of this crisis are enormous. Fortunately, Congress is taking action to identify and combat the actors most responsible for introducing illicit fentanyl into the United States: Chinese laboratories and Mexican drug cartels.

These two criminal enterprises work as a team to deliver these deadly drugs to our streets. Most fentanyl and the ingredients required to synthesize the drug are manufactured in China and shipped to Mexico, where it is then smuggled into the United States. The problem has become so bad that last year alone, more than 1,800 pounds of fentanyl was seized at the border, a 2,500 percent increase from just four years ago.

Congress is currently considering several versions of a bill known as the Fentanyl Sanctions Act, with an eye toward stopping the spread of the drug at its source. The legislation would enact sanctions on foreign manufacturers and traffickers of synthetic opioids, establish a Commission on Synthetic Opioid Trafficking, and authorize new funding to bolster the anti-smuggling efforts of U.S. law enforcement and intelligence agencies. If enacted, the bill would go a long way toward curbing the supply of illicit drugs pouring over our border.

We must also be sure to focus on treatment programs for those suffering from opioid dependency. As the former executive director of a drug and alcohol recovery program, I understand how difficult it can be for drug users to break the cycle of addiction.

Insurance coverage for treatment programs and mental health services is inconsistent, and policymakers should encourage the expansion of these benefits. Pilot programs such as Denver’s “Treatment on Demand,” which offers patients same-day, medication-assisted treatment, should receive additional funds as they prove successful.

Also, funding for initiatives such as “Access to Recovery,” a program piloted under President George W. Bush that provided those suffering from addiction a voucher to choose the treatment option that would help them the most, should be reinstituted. Finally, as funds start to flow in from opioid lawsuit judgments and settlements, we must be sure this money is not redirected for other purposes, as was the case with the national tobacco settlement. Instead, it should be sent directly to providers for much-needed treatment programs.

The progress we have made in reining in overdose deaths from prescription opioids and heroin has shown that we can make similar headway in the fight against fentanyl. In order to win this fight once and for all, though, we must be sure that the public policy prescriptions coming out of Washington match the reality of what is happening on the ground.


Ken Summers is a former member of the Colorado Attorney General’s Drug Trend and Response Task Force and the former chair of the Health Committee in the Colorado House of Representatives.

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