on Combating Drug Addiction and the Opioid Crisis

On October 26, 2017, the President of the United States declared the opioid crisis a national public health emergency under federal law. Amid continued public outcry for government reform and regulation to stem the tide of the opioid crisis, the President has assigned a taskforce to examine the issue and produce recommendations based on their findings.

These recommendations address 4 categories that outline a viable path toward bringing an end to this epidemic. Highlights of the recommendations are below.

Follow the link in each section to read the full report and all 56 recommendations.
Disclaimer: Information from the President’s Commission on Combating Drug Addiction (report dated 11/15/2017) is presented on this site for discussion and awareness purposes only. It is not intended to interpret or modify in any manner the recommendations provided in the official report which may be accessed at https://www.whitehouse.gov/ondcp/presidents-commission.

CATEGORIES OF RECOMMENDATIONS

RECOMMENDATION HIGHLIGHTS AND SELECTED STATISTICS FROM THE REPORT

FEDERAL FUNDING AND PROGRAMS


38%
OF US COUNTIES DID NOT HAVE ANY TREATMENT FACILITIES FOR SUBSTANCE USE DISORDER (SUD) AS OF 20161
RECOMMENDATION:
IMPLEMENT BLOCK GRANTS

The Commission urges Congress and the Administration to implement block grants (large sums of money granted by the federal government) for opioid-related and SUD-related activities to the states, where the battle is happening every day. There are multiple federal agencies and multiple grants within those agencies that cause states a significant administrative burden from an application and reporting perspective. Creating uniform block grants would allow more resources to be spent on administering life-saving programs. This was a request to the Commission by nearly every governor, regardless of party, across the country. [Recommendation 1]


$12 Million was requested for the residential substance abuse treatment (rsat) program for state prisoners in fy 2018—this number has not increased since fy 20161

$25 Million WAS REQUESTED IN THE FY 2018 BUDGET TO SUPPORT THE MEDICATION-ASSISTED TREATMENT (MAT) FOR PRESCRIPTION DRUG AND OPIOID ADDICTION PROGRAM—A NUMBER THAT HASN’T INCREASED SINCE FY 20161

85% of US counties did not have opioid treatment programs that provide mat for people diagnosed with opioid use disorder (oud) as of 20161

RECOMMENDATION:
ESTABLISH TRACKING AND ACCOUNTABILITY

The Commission believes that the Office of National Drug Control Policy (ONDCP) must establish a coordinated system for tracking all federally funded initiatives, through support from the Department of Health and Human Services (HHS) and the Department of Justice (DOJ). If we are to invest in combating this epidemic, we must invest in only those programs that achieve quantifiable goals and metrics. We are operating blindly today; ONDCP must establish a system of tracking and accountability. [Recommendation 2]

RECOMMENDATION:
INCREASE FEDERAL AND STATE COOPERATION

To achieve accountability in federal programs, the Commission recommends that ONDCP review is a component of every federal program and that necessary funding is provided for implementation. Cooperation by federal agencies and the states must be mandated. [Recommendation 3]

OPIOID ADDICTION PREVENTION


152,000
ADOLESCENTS AGED 12-17 HAD A PAIN RELIEVER USE DISORDER IN THE PAST YEAR1
RECOMMENDATION:
IMPLEMENT SCREENING AND INTERVENTION PROGRAMS FOR ADOLESCENTS

The Commission recommends that the Department of Education (DOE) collaborate with states on student assessment programs such as Screening, Brief Intervention, and Referral to Treatment (SBIRT). SBIRT is a program that uses a screening tool by trained staff to identify at-risk youth who may need treatment. This should be deployed for adolescents in middle school, high school, and college levels. This is a significant prevention tool. [Recommendation 4]


Meth Project

56% decline in meth use among teens in idaho as a result of the meth project since 20071

The Meth Project is a large-scale awareness ad campaign founded in 2005 with the aim to reduce methamphetamine use.

RECOMMENDATION:
LAUNCH A NATIONAL MEDIA CAMPAIGN

The Commission recommends the Administration fund and collaborate with private sector and non-profit partners to design and implement a wide-reaching, national multi-platform media campaign addressing the hazards of substance use, the danger of opioids, and stigma. A similar mass media/educational campaign was launched during the AIDS public health crisis. [Recommendation 5]


Nearly 250 million opioid prescriptions were written in 2013. that’s enough for every american adult to have a bottle of prescription opioids1

RECOMMENDATION:
ENSURE INFORMED CONSENT

The Commission recommends the development of model statutes, regulations, and policies that ensure informed patient consent prior to an opioid prescription for chronic pain. Patients need to understand the risks, benefits, and alternatives to taking opioids. This is not the standard today. [Recommendation 6]

RECOMMENDATION:
IMPROVE PHARMACY TRAINING

The Commission recommends that the Department of Health and Human Services (HHS), Department of Justice (DOJ)/Drug Enforcement Agency (DEA), Office of National Drug Control Policy (ONDCP), and pharmacy associations train pharmacists on best practices to evaluate legitimacy of opioid prescriptions, and not penalize pharmacists for denying inappropriate prescriptions. [Recommendation 11]

RECOMMENDATION:
INFORM THE PUBLIC ABOUT SCREENING AND TREATMENT SERVICES

The Commission recommends community-based stakeholders utilize National Prescription Drug Take Back Day to inform the public about drug screening and treatment services. The Commission encourages more hospitals/clinics and retail pharmacies to become year-round authorized collectors and explore the use of drug deactivation bags. [Recommendation 17]

OPIOID ADDICTION TREATMENT, OVERDOSE REVERSAL, AND RECOVERY


1.6 million

ADULTS IN THE US HAD OPIOID USE DISORDER (OUD) IN 20151
RECOMMENDATION:
IMPROVE SCREENING FOR SUDS

The Commission recommends federal agencies incorporate quality measures that address addiction screenings and treatment referrals. There is a great need to ensure that healthcare providers are screening for substance use disorders (SUDs) and know how to counsel patients appropriately. The Department of Health and Human Services (HHS) should review the scientific evidence on the latest OUD and SUD treatment options and collaborate with the U.S. Preventive Services Task Force on provider recommendations. [Recommendation 31]

RECOMMENDATION:
IMPLEMENT GUIDELINES AND POLICIES FOR RECOVERY PROGRAMS

The Commission recommends that HHS implement guidelines and reimbursement policies for Recovery Support Services, including peer-to-peer programs, jobs and life skills training, supportive housing, and recovery housing. [Recommendation 46]

Only 10.6% of adolescents and adults who required treatment for sud received the help they needed in the past year1

RECOMMENDATION:
REMOVE BARRIERS TO TREATMENT

The Commission recommends the removal of reimbursement and policy barriers to SUD treatment. This includes those that limit access to any form of FDA-approved medication-assisted treatment (MAT), counseling, inpatient/residential treatment, and other treatment modalities—particularly fail-first protocols and frequent prior authorizations. [Recommendation 33]

RECOMMENDATION:
LEVERAGE TELEMEDICINE

The Commission recommends that federal agencies revise regulations and reimbursement policies to allow for SUD treatment via telemedicine. [Recommendation 41]

RECOMMENDATION:
PROVIDE MAT IN CORRECTIONAL INSTITUTIONS

The Commission recommends that the National Institute of Corrections, the Bureau of Justice Assistance, the Substance Abuse and Mental Health Services Administration, and other national, state, and local stakeholders use MAT with pretrial detainees and continue treatment upon release. [Recommendation 37]

RESEARCH & DEVELOPMENT


RECOMMENDATION:
REVIEW EXISTING RESEARCH

The Commission recommends that federal agencies should engage in a comprehensive review of existing research programs and establish goals for pain management and addiction research (both prevention and treatment). [Recommendation 52]

38%
HAS BEEN REQUESTED FOR FY 2018 FOR GRANTS TO 10 STATES TO SIGNIFICANTLY REDUCE THE NUMBER OF OPIOID OVERDOSE-RELATED DEATHS, INCLUDING EQUIPPING FIRST RESPONDERS WITH NALOXONE1
RECOMMENDATION:
FUND RESEARCH OF INNOVATIVE MEDICATIONS

The Commission recommends Congress and the Federal Government provide additional resources to the National Institute on Drug Abuse (NIDA), the National Institute of Mental Health (NIMH), and National Institute on Alcohol Abuse and Alcoholism (NIAAA) to fund research. NIDA should continue research in concert with the pharmaceutical industry to develop and test innovative medications for substance use disorders (SUDs) and opioid use disorder (OUD), including long-acting injectables, more potent opioid antagonists to reverse overdose, drugs used for detoxification, and opioid vaccines. [Recommendation 53]


More than 20 opioid analgesic formulations are currently approved by the fda, and an additional 52 applications for approval are being considered1

RECOMMENDATION:
FAST-TRACK NEW TECHNOLOGIES

The Commission recommends further research of Technology-Assisted Monitoring and Treatment for high-risk patients and SUD patients. The Centers for Medicare and Medicaid Services (CMS), FDA, and the United States Preventative Services Task Force (USPSTF) should implement a fast-track review process for any new evidencebased technology supporting SUD prevention and treatments. [Recommendation 54]