The Moral Ethics of Solution to Opioid Epidemic

Drug overdose is one of the leading causes of death in America and across the world. According to recent world headlines, “in 2015, about 300 million opioid prescriptions were written, with more than 80% being written in the United States” (Davidson). According to author Tish Davidson, this is only one part of the “American public health crisis caused by addiction to both prescription and illegal opioid painkillers,” better known as the Opioid Crisis. The United States employs current policies that blur the line between “cops vs docs” in the current actions mitigating the harmful effects of the Opioid epidemic. Such policies include confusing the public’s interest in reducing opioid-related fatalities and the need to provide healthy pain relief methods for individuals suffering from a variety of mental and physical ailments.

In addition, the Opioid Crisis is not just a problem in the United States, but across the globe. However, new research has shown that particular “strategies [have been] successfully implemented elsewhere around the world” suggesting that America ought to adopt new procedures to this greater global issue (Bach and Hartung ). Furthermore, legal settlements alone will not alleviate the rippling effects of America’s Opioid Crisis. According to recent conclusions published in The Economist (Vol. 432, Issue 9158), legal settlements “will run to hundreds of billions of dollars” and ultimately the “damages from pharma companies should go directly into alleviating the harm from opioids rather than into general government spending” (The Economist). However, the past 25 years of marketed prescription have left lasting repercussions on America and ultimately the “generous settlements with drug firms and distributors will not foot the entire bill” (The Economist). This indicates that alongside the proper legal settlements, America is in dire need of the proper resources to spread comprehensive awareness and screening of opioid prescriptions.

In order to solve the opioid epidemic and maintain awareness around mental health, wellness, and personal development, America ought to prevent the autonomy of corrupt pharmaceutical companies and spend the money gained from these lawsuits to fund recovery programs instead of simply criminalizing drug misuse.

The major problem observed with the current “cops vs docs” criminalizing system illustrates that America is misprioritizing the prevention of opioid-related fatalities and the providing of pain relief options. The reason why the opioid epidemic is such a controversial issue is that society lacks communication of goals. While communities do want to stop the overuse and prescription of opioids, they misunderstand that this problem affects the health of all people and cannot just simply criminalize the substance. In fact, author Raymond Barglow argues that “even imprisonment often does not result in total abstinence; inmates manage in one way or another to obtain substances that sustain their habit, and indeed, 95 percent of those addicted at the time of incarceration return to drug abuse upon release” (Barglow 5). In addition, this, in fact, mirrors the results of the late Prohibition law, as Barglow suggests that this current policy of banning substance has not evolved from its “problematic history”, indicating that a “supply restriction may actually strengthen addictive habits rather than suppress them” (4). Moreover, the majority of people suffering from the fatal effects of the opioid crisis are in fact simply trying to treat pain and opioids are often the first or only options for treatment. This ultimately raises the question: should society punish those who are simply trying to treat pain?

Unfortunately, many critics are under the perception that pain is being overtreated and consequently many patients will suffer from fatal addictions. While this is a valid concern, author Michelle Vallet claims that “opioids do have a place in pain management, especially when treating trauma, like for soldiers injured during combat or the person who comes into the ER after being in a car accident” (Vallet). Therefore, it would not make sense to simply just ban and criminalize all use of opioid substances, as Vallet suggests that for many patients, opioids are oftentimes the only or most effective treatment options. While critics may argue that other non-opioid treatment options are available and may be further developed in the future, the fact remains that despite the possibility of addiction, opioids are still used to primarily benefit the help of most users. Generally, the constant public battle between “cops vs docs” that has risen consequently to the opioid epidemic requires immediate attention and reform. Simply speaking, the opioid crisis cannot just be simply solved through the banning of all opioid use ergo it will ultimately lead to a rise of a larger black market, decline in pain treatment options, and will not simply stop all use of opioids. Furthermore, the legal settlements made by pharmaceutical companies will not solve America’s opioid crisis alone.

According to “Avoidable pain; Opioids” some drugmakers are beginning to make amends by shouldering much of the blame for the opioid epidemic. For example, a report from the “The Economist” states that “there are encouraging signs that Purdue Pharma, which lies at the origin of the epidemic, may settle a batch of lawsuits for up to $12bn” (The Economist). This exhibits that the root of the opioid epidemic is being addressed and highlighting that many of America’s legal actions are focusing on the marketing of prescriptions from “pill-mills,” where prescribers dispense opioids without a valid prescription or medical need. However, the same article also suggests that many of these prescription makers are accepting blame quickly but not learning from the “lacking” consequences. Generally speaking, it is perceived that “many drug distributors and pharmacies, [are still] mesmerized by growing sales, [failing] to take action…” as the current system places “sales and 'customer' satisfaction before patients' well-being” (The Economist). Therefore, it is obvious that there is a growing problem with the lack-luster legal settlements and the continuation of both prescription and illegal opioid sales. Pharmaceutical companies need to reform their current business mindset and simply focus on the general health of all Americans rather than making money. Overall, both the excessive and sometimes illegal prescribing practices in the pharmaceutical industries are described to be the root of the opioid epidemic around the world, and the United States of America must reform its current policies to find an end to this problem.

Any solution to this problem must be assiduous with both the public’s attempt to solve the unsupervised use of opioids and similar substances while still providing an effective pain treatment option. Therefore, America must seek a more enlightened motion towards educating younger generations about the harmful effects drug use and the effects the opioid crisis has on society. According to research across the world, an education-based solution has proven to be effective and ultimately reduce the drug mortality rate. For example, Portugal “decriminalized illicit drug use in 2001 and then funded addiction treatment programs and a public information campaign. Education about drug use became part of the standard Portuguese high-school curriculum” (Barglow). As a result, this harm reduction based policies continue to help “reduce the country's per-capita drug mortality rate, which today is about 50 times lower than that of the U.S” (Barglow). Therefore, a harm-free approach to both the education and criminalization of drug users helps prevent future use and help educate current users.

In addition, according to an article in the Chain Drug Review, “CVS pharmacists [now] visit local schools in their community to talk to students and parents about the dangers of misusing prescription drugs using a curriculum developed” program, suggesting that education surrounding both the opioid epidemic and proper use of opioid substances is necessary to address and prevent future and current opioid abuse. While this is a solid approach to addressing and solving the opioid crisis as it addresses many of the people at risk from this epidemic at a daily level. This has even been proven to work across the globe. However, some of the problems with this solution is that it is hard to educate the majority of people who suffer from abuse. This solution many focuses on the prevention of future use rather than addressing those who may misuse opioids on a regular basis. This solution also suffers from the possible lack of support by all health care providers. Overall, the weaknesses of this solution clearly outweigh the benefits, as public education will not reach the main opioid users, therefore not making it a viable solution.

America must seek a harm-reduction approach to replace criminalization with programs centered around educating the public and allow addicts to engage in their own recovery. Authors Bach and Hartung describe that one of the most effective “treatment of substance use disorders…[is] operating out of designated addiction treatment facilities.” Once there, specialized physicians and psychiatrists help educate and promote a healthy mind and body lifestyle along with their patients’ insights and consent. Furthermore, education-based treatment clinics may also aid addicts to help in the process of recovery. By helping enlighten addicts about their current problems, specialized treatment clinics may also replace criminalization in this scenario. Generally speaking, society should send addicts to a form of educated treatment as an alternative to jail. Ultimately this would effectively provide a plausible solution to the “cops vs docs” argument. However, this solution also faces many problems as author Tish Davidson states that the “establishment of drug treatment clinics is often hampered by neighborhood opposition and lack of funding”. Furthermore, Davidson adds that “President Trump’s 2017 declaration of the opioid epidemic as a public health emergency did not provide additional funds for clinics.” As a result, Bach and Hartung further illustrate that “accessing addiction treatment particularly difficult for rural and/or marginalized populations” can make recovery even more difficult. Patients can receive effective treatment with specialized treatment processes. However, funding for these clinics is nearly non-existent. In addition, these clinics are rather far spread geographically, making it difficult for many people to access. Overall, the solution to creating more addition clinics and providing more funding for the prior appears to be an extremely effective option. However, due to the lack of proper funds and accessibility, makes it a rather weaker solution.

In conclusion, the most effective and feasible solution in solving the opioid crisis is to create a more effective and higher screening process for pharmacists and prescriptions. The first reason why this is the best solution is that according to Paxton Bach and Daniel Hartung is supporting and increasing the role of pharmacists in the prevention, treatment, and surveillance of opioid prescriptions. Specifically, they describe that the pharmacists are typically the best line of defense for patients before dispensing “prescription medications,[as] they are well positioned to screen for diversion, monitor for potentially problematic use of prescription opioids, and educate patients about opioid-related risks” proving that the most effective healthcare surveillance would come from the pharmacists as they would be required to be “vigilant for behavior ... such as fills at multiple pharmacies, early fills, cash payments, or prescriptions from several prescribers.” Specifically, pharmacists could effectively observe behaviors, possible including those who may display the features of an OUD.

Additionally, this would effectively limit access for these drugs as well as give pharmacists a larger role in preventing future or current OUDs. According to Tish Davidson, “all fifty states as of late 2017 have developed or are developing prescription drug registries to track opioid prescriptions.” This would ultimately help reduce the misuse of opioids because it “prevent[s] a single individual from getting multiple prescriptions simultaneously from different doctors and to track[s] doctors who write prescriptions for excessively large amounts of opioids.” Taking everything into account, given the direct line of defense, this solution would lead directly to patient health improvement, because it attacks the problem of overprescription and other ill-natured intents. Therefore, the opioid crisis can best be resolved by levying the role of pharmacists in this epidemic.

The mortal effects stemming from the opioid crisis is a problem that not only is prevalent within the united states but is a vital issue on a larger global scale. The current legal and local systems fail in providing both awareness about the problems and lack the solutions to address it, however through some few minor changes to the system, we are now able to address and help mitigate the effects of this epidemic. No more corrupt pharmaceutical companies should be allowed to simply give out possible harmful prescriptions without the proper screening and education of the patient. If America embraces these harm-reduction policies and reforms, America can essentially become the leading country in the battle against the opioid crisis. Fundamentally speaking, America can ultimately get rid of the leading cause of death for most Americans. No more parent, child, or friend should have to suffer the loss of a loved one who simply was seeking to numb pain. All in all, America needs to make improvements both at the prescription level and the enhanced prevention and rehabilitation education, and only then will America be able to halt the consequences posed to the public by the opioid crisis.