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The Capitolist: Stemming the Opioid Crisis – How Congress Can Make Progress

Monday, March 26, 2018


The following is a guest contribution by Sal Nuzzo of the James Madison Institute and is the opinion of the author.

We are facing the worst drug epidemic in American history. According to data from the Centers for Disease Control (CDC), in 2016 more than 42,000 people died of opioid overdoses; this amounts to just over 115 people dying per day. Opioids do not discriminate. People from every corner of the U.S. regardless of race, color, or creed are struggling with addiction and dying at alarming rates. In an unprecedented situation such as this, public intervention can be justified by even those who advocate for limited government. The role of the federal government is to respond to national emergencies, and there is little doubt that the opioid epidemic qualifies as such.

We are facing the worst drug epidemic in American history. According to data from the Centers for Disease Control (CDC), in 2016 more than 42,000 people died of opioid overdoses; this amounts to just over 115 pe

Using federal tax dollars appropriately is critical in this fight. Both the administration and congressional lawmakers recognize that their strategies must be effective. As executive orders are issued, task forces formed, congressional hearings are planned, policies are proposed, and grants are distributed, we still struggle to make headway in this crisis.

Investments at the local level continue to be the best way to prevent overdoses and get people the treatment they need. One strategy for government to facilitate this is by increasing funding for naloxone, a medication designed to reverse opioid overdoses. It works by attaching to the receptors within the brain that opioids target, blocking their impact. It has been used for years and has proven to be extremely effective and safe.

Many states have recognized the power and significance of naloxone when designing interventions to curb the opioid epidemic. Regulations have been updated, educational programs have been implemented and pharmacies have increased supplies of this overdose-reversing drug. However, more can be done to prevent overdoses in our communities.

One important and targeted intervention that should be implemented without delay is equipping law enforcement officers with this powerful drug. Over 75 percent of opioid deaths take place outside of a medical setting. Police officers are at the front lines of the epidemic, they are often the first on the scene, arriving before EMS and other medical services. They need to be able to respond to overdose emergencies immediately. Law enforcement officers are trained to respond to other medical emergencies, they know CPR, how to stop bleeding, and triage victims. Why shouldn’t they also be prepared to respond to an opioid overdose? Additionally, because they are at the front lines, they are in danger of being directly exposed to these highly potent drugs through residue and powder. An accidental ingestion should never be a death sentence for an those we task with protecting the public. We should do everything possible to ensure that all law enforcement officers have access to naloxone in their patrol cars.

A second policy that would make an enormous difference is increasing the use of naloxone co-prescription. The federal government can set an example by encouraging co-prescription in federally-funded health care programs. This is a cost-effective initiative that will most importantly save lives, but also reduce government expenditures. Opioids are especially threatening to the elderly. In fact, as data from the Department of Health and Human Services Inspector General show, one in three Medicare Part D beneficiaries received an opioid prescription in 2016.

To provide patients who need it with this life-saving drug, the Centers for Disease Control (CDC) recommends that naloxone be co-prescribed in certain situations. Naloxone is recommended for all patients receiving high doses of opioids, for patients who take opioids in combination with certain medications, and for those who have a history of substance abuse. These patients are at a higher risk for misuse or accidental overdose. Requiring the Center for Medicare and Medicaid Services (CMS) to follow the CDC’s prescribing recommendations will save lives in a fiscally responsible way. Opioid-related ICU admissions are skyrocketing in number, and the average cost is up to $92,000 per overdose. Studies show that administering naloxone immediately following an overdose decreases the likelihood of hospitalization, ultimately reducing costs. Medicare and Medicaid pay for 50 percent of opioid related ED visits and 68 percent of opioid related hospitalizations. Implementing this policy is a win for both patients and taxpayers. Getting this powerful drug into the hands of local doctors will make a difference in communities across the United States.

The Senate Appropriations Committee is currently deciding how to distribute federal funds to fight the epidemic. Congress should act now and allocate appropriate funding to help local law enforcement and medical professionals fight back against this epidemic. They have the power to put this life saving drug in the hands of patients and first responders who need it most. We all must work together to find the most effective solutions to the opioid emergency. Valuing life means getting people the care they need and increasing access to naloxone is an essential part of that effort.

Sal Nuzzo, Vice President of Policy, James Madison Institute


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