Recognizing opioid epidemic as catastrophe

Fatal aviation disasters are a rare event in the modern age. It would come as a shock to hear of a passenger jet crashing and killing everyone aboard. Now try to imagine it happening today, tomorrow, the next day and the day after. That will give you an idea of the death toll from drug overdoses in the United States.

Last year, according to a preliminary estimate from the Centers for Disease Control and Prevention, 72,000 lives were lost to overdoses. That’s 197 people dying every day — more than enough to fill a Boeing 737 passenger jet. It’s an increase of more than 6 percent over 2016 . ...

Unlike airline crashes, these tragedies happen one by one, usually out of sight, unnoticed except by family, friends, first responders and emergency room personnel. But the staggering figures represent a crisis of historic proportions. The toll last year is nearly double the number of gun deaths in 2016. Though the CDC says the death rate from drug overdoses fell in a few states, it’s clear that in most places, efforts to combat this scourge are still falling short.

Two-thirds of the deaths involve opioids, including heroin, prescription painkillers and synthetic drugs such as fentanyl. The latter substances play by far the biggest role in the increase. Fentanyl is cheap and about 50 times more potent than heroin. When drug dealers mix it into their heroin supplies to save money, unsuspecting users can easily ingest a fatal amount.

Reversing the deadly tide is not easy. So far, the effort has been mounted on several fronts. Law enforcement has targeted suppliers, particularly those shipping fentanyl from China and Mexico. Public health agencies and medical providers have tried to expand access to treatment for those who are addicted — many of whom started by using opioids prescribed by their doctors and eventually resorted to black-market alternatives.

A multitude of lawsuits have been filed against pharmaceutical companies by local and state governments (including Chicago, Cook County and Illinois) and other parties accusing pharmaceutical companies of marketing these powerful drugs in an irresponsible way. Last week, President Donald Trump called on the Justice Department to consider filing a federal lawsuit as well.

This type of litigation may bring about changes in marketing and recover monetary damages. But it won’t eliminate dependence on the drugs that are doing so much damage. Attorney General Jeff Sessions has tripled the number of fentanyl prosecutions, including one against Chinese distributors, which may reduce the likelihood of lethal combinations. Equipping police and paramedics with naloxone, which can reverse overdoses, has saved a lot of lives.

The ultimate remedy, though, is to reduce demand by educating doctors and patients about the dangers of over-reliance on opioids, facilitating access to treatment and encouraging drug users to get it. The U.S. Department of Health and Human Services website has a feature to let those in need find treatment facilities in their ZIP codes. Some hospitals in California have begun giving overdose patients medications for managing withdrawal — which is demonstrably helpful in getting them to enter treatment afterward. Vermont has reduced overdose deaths by taking steps to better integrate such treatment into primary care.

Governments need to make a priority of expanding access to those who lack health insurance coverage. Last year, a presidential commission reported that only 10.6 percent of those who need substance abuse therapy actually get it . ...

Preventing many or most of these fatalities will not be an easy undertaking. But the chances of success will be much better if our policymakers recognize this epidemic as the national catastrophe it has become.