NCAD: Resources, not rhetoric, will combat the addiction crisis

The disease of addiction continues to be viewed differently than other health conditions. Leana Wen, MD, health commissioner of Baltimore City, emphasized how such attitudes toward substance use disorders translate to resources, speaking at the opening keynote of the National Conference on Addiction Disorders (NCAD) in Baltimore.

For example, federal officials have spoken of a national state of emergency for the opioid crisis, but practical action has lagged thus far. No other health emergency would be met with such a delay, Wen said.

“Imagine if there were 142 people a day dying from an infectious disease like Ebola or a natural disaster—there would be no question of a state of emergency,” she told Behavioral Healthcare Executive in an exclusive interview at NCAD. “I’d like to see not only rhetoric but what specific resources we are going to devote to this epidemic.”

A White House commission examining the opioid crisis, led by Gov. Chris Christie of New Jersey, issued its initial feedback in a report on July 31, and the recommendation presented first and foremost was advising the president to declare the crisis a national state of emergency. A week later, Trump and federal officials indicated serious concern but stopped short of the declaration. On August 10, Trump more explicitly said he was declaring a state of emergency.

“We were very happy to hear the president say that he was going to declare a national emergency, and we’re excited to see what those next steps will be,” said Kenneth Shatzkes, PhD, policy advisor for Christie, in an exclusive interview. 

A spokesperson from the White House also told Behavioral Healthcare Executive in an email that the president’s instructions for his administration to take all appropriate and emergency measures to confront the crisis are currently undergoing expedited legal review.

Shatzkes said the opioid crisis is Christie’s primary focus right now and that he understands the magnitude of the issue.

 “This is a solvable problem,” Wen said. “There are treatments available and the science to support these treatments. We need to get these resources, and we need to get them now.”

Baltimore at the forefront

During the NCAD plenary presentation, Wen also told attendees that resources are the limitation to saving lives. In Baltimore, she has issued a standing order to allow pharmacies to dispense naloxone without a prescription. First responders also carry the overdose reversal drug.

But funding to purchase naloxone for public health isn’t unlimited, of course.

“We are literally out of naloxone,” Wen said. “We had to ration it to last between now and July 2018, and we only have 5,000 units. We have to find who is more likely to die of overdose. Who is it we give the limited supply of medication to?”

Wen said 1,100 lives have already been saved by naloxone since the standing order went into effect.