The Politics Of The Opioid Epidemic

In "The Politics of the Opioid Epidemic," leading political scientists from diverse theoretical traditions provide new insights into the enduring features of American policy and practice that have influenced state-level and national responses to the ongoing opioid crisis. Key among these features is the persistent power of race in shaping public opinion of the opioid crisis, influencing the development of punitive and treatment-oriented legislation, and impacting media portrayal of opioids and the communities they affect. Other factors include the development of the conservative welfare state and the challenges of delivering information and services to affected communities through existing, dysfunctional systems. Analyzing the manifold politics that have contributed to the current situation, contributors explain the depth of the current opioid epidemic and highlight the need for structural change to produce durable, effective policies. Contributors. Amanda Abraham, Christina M. Andrews, Clifford S. Bersamira, Andrea Louise Campbell, Sarah E. Gollust, Colleen M. Grogan, Gali Katznelson, Jin Woo Kim, Miriam Laugesen, Joanne M. Miller, Susan L. Moffitt, Evan Morgan, Brendan Nyhan, Eric M. Patashnik, Elizabeth Per z-Chiqu s, Harold A. Pollack, Marie Schenk, Carmel Shachar, Phillip M. Singer, Bikki Tran Smith, Patricia Strach, Paul Testa, Tess Wise, Katie Zuber

Drug overdose, driven largely by overdose related to the use of opioids, is now the leading cause of unintentional injury death in the United States. The ongoing opioid crisis lies at the intersection of two public health challenges: reducing the burden of suffering from pain and containing the rising toll of the harms that can arise from the use of opioid medications. Chronic pain and opioid use disorder both represent complex human conditions affecting millions of Americans and causing untold disability and loss of function. In the context of the growing opioid problem, the U.S. Food and Drug Administration (FDA) launched an Opioids Action Plan in early 2016. As part of this plan, the FDA asked the National Academies of Sciences, Engineering, and Medicine to convene a committee to update the state of the science on pain research, care, and education and to identify actions the FDA and others can take to respond to the opioid epidemic, with a particular focus on informing FDA's development of a formal method for incorporating individual and societal considerations into its risk-benefit framework for opioid approval and monitoring.

The current opioid epidemic in the United States began in the mid-1990s with the introduction of a new drug, OxyContin, viewed as a safer and more effective opiate for chronic pain management. By 2017, the opioid epidemic had become a full-blown crisis as over two million Americans had become dependent on and abused prescription pain pills and street drugs. This book examines the origins, development, and rise of the opioid epidemic in the United States from the perspective of the public policy process. The authors, political scientists Kant Patel and Mark Rushefsky, discuss institutional features of the American political system that impact the making of public policy, arguing that the fragmentation of that system hinders the ability to coherently address policy problems, taking the opioid epidemic as an example. The book begins with a brief historical examination of the history of the problem of opioid addiction and crises in the United States and public policy responses to past crises, but the main focus is on the current national public health emergency. The book analyzes the following: The origins of the current crisis Indicators and warning signs pointing to the emergence of a significant public problem Factors that contributed to the opioid crisis Why the crisis emerged in the United States and not in other Western countries The nature and scope of the opioid crisis, including socioeconomic and demographic characteristics and the human, social, and economic costs Presidential administrations’ public response, and nonresponse, to the opioid crisis Parallels between the role played by opioid manufacturers and tobacco/cigarette manufacturers in creating the problem of addiction, resulting in high mortality rates, and the public policy response to both This book explores the national policy response to the opioid crisis, as well as state and local government responses and separation of powers, including how the three branches of government deal with the opioid problem. The authors conclude with a discussion of how accurate problem definition, problem diagnosis, and appropriate and timely responses could have produced a more appropriate and robust policy response—policy process tools that will be essential in fighting both the current crisis and the next one. The Opioid Epidemic in the United States is essential reading for policy analysis courses in political science, health, and social work programs, as well as for United States policymakers at the local, state, and national levels.

The opioid crisis in the United States has come about because of excessive use of these drugs for both legal and illicit purposes and unprecedented levels of consequent opioid use disorder (OUD). More than 2 million people in the United States are estimated to have OUD, which is caused by prolonged use of prescription opioids, heroin, or other illicit opioids. OUD is a life-threatening condition associated with a 20-fold greater risk of early death due to overdose, infectious diseases, trauma, and suicide. Mortality related to OUD continues to escalate as this public health crisis gathers momentum across the country, with opioid overdoses killing more than 47,000 people in 2017 in the United States. Efforts to date have made no real headway in stemming this crisis, in large part because tools that already existâ€"like evidence-based medicationsâ€"are not being deployed to maximum impact. To support the dissemination of accurate patient-focused information about treatments for addiction, and to help provide scientific solutions to the current opioid crisis, this report studies the evidence base on medication assisted treatment (MAT) for OUD. It examines available evidence on the range of parameters and circumstances in which MAT can be effectively delivered and identifies additional research needed.

An incisive, essential guide to understanding one of today's most urgent -- and complex -- problems. The Opioid Epidemic: What Everyone Needs to Know® is an accessible, nonpartisan overview of the causes, politics, and treatments tied to the most devastating health crisis of our time. Its comprehensive approach and Q&A format offer readers a practical path to understanding the epidemic from all sides. Written by two expert physicians and enriched with stories from their experiences on the front lines of this epidemic, this book is a critical resource for any general reader -- and for the individuals and families fighting this fight in their own lives.

A comprehensive portrait of a uniquely American epidemic -- devastating in its findings and damning in its conclusions The opioid epidemic has been described as "one of the greatest mistakes of modern medicine." But calling it a mistake is a generous rewriting of the history of greed, corruption, and indifference that pushed the US into consuming more than 80 percent of the world's opioid painkillers. Journeying through lives and communities wrecked by the epidemic, Chris McGreal reveals not only how Big Pharma hooked Americans on powerfully addictive drugs, but the corrupting of medicine and public institutions that let the opioid makers get away with it. The starting point for McGreal's deeply reported investigation is the miners promised that opioid painkillers would restore their wrecked bodies, but who became targets of "drug dealers in white coats." A few heroic physicians warned of impending disaster. But American Overdose exposes the powerful forces they were up against, including the pharmaceutical industry's coopting of the Food and Drug Administration and Congress in the drive to push painkillers -- resulting in the resurgence of heroin cartels in the American heartland. McGreal tells the story, in terms both broad and intimate, of people hit by a catastrophe they never saw coming. Years in the making, its ruinous consequences will stretch years into the future.

The history of an unnatural disaster—drug overdose—and the emergence of naloxone as a social and technological solution. For years, drug overdose was unmentionable in polite society. OD was understood to be something that took place in dark alleys—an ugly death awaiting social deviants—neither scientifically nor clinically interesting. But over the last several years, overdose prevention has become the unlikely object of a social movement, powered by the miracle drug naloxone. In OD, Nancy Campbell charts the emergence of naloxone as a technological fix for overdose and describes the remaking of overdose into an experience recognized as common, predictable, patterned—and, above all, preventable. Naloxone, which made resuscitation, rescue, and “reversal” after an overdose possible, became a tool for shifting law, policy, clinical medicine, and science toward harm reduction. Liberated from emergency room protocols and distributed in take-home kits to non-medical professionals, it also became a tool of empowerment. After recounting the prehistory of naloxone—the early treatment of OD as a problem of poisoning, the development of nalorphine (naloxone's predecessor), the idea of “reanimatology”—Campbell describes how naloxone emerged as a tool of harm reduction. She reports on naloxone use in far-flung locations that include post-Thatcherite Britain, rural New Mexico, and cities and towns in Massachusetts. Drawing on interviews with approximately sixty advocates, drug users, former users, friends, families, witnesses, clinicians, and scientists—whom she calls the “protagonists” of her story—Campbell tells a story of saving lives amid the complex, difficult conditions of an unfolding unnatural disaster.

"The Opioid Epidemic and US Culture brings a new set of perspectives to one of the most pressing contemporary topics in Appalachia and the nation as a whole. A project aimed both at challenging dehumanizing attitudes toward those caught in the opioid epidemic and at protesting the structural forces that have enabled it, this edited volume assembles a multidisciplinary community of scholars and practitioners to consider the ways that people have mobilized their creativity in response to the crisis. Written for an audience of people working on the front lines of the opioid crisis, the book is essential reading for social workers, addiction counselors, halfway house managers, and people with opioid use disorder. It will also appeal to the community of scholars interested in understanding how aesthetics shape our engagement with critical social issues, particularly in the fields of literary and film criticism, museum studies, and ethnomusicology"--