UMN Experts: Opioid addiction crisis is a public health emergency
The White House administration today declared the opioid addiction crisis a public health emergency. The designation could spur awareness campaigns and potentially bolster funding for prevention efforts over a 90-day period. University of Minnesota health experts Laura Palombi, PharmD, MPH; Katy Kozhimannil, PhD, MPA; Sarah Gollust, PhD, provide tangible examples of how awareness and funding could prompt action and turn the tide on opioid addiction.
Laura Palombi, Pharm.D, MPH
“Near term, I’m hopeful a designation of some kind would allocate at least some funding for cash-strapped counties that aren’t able to afford a reasonable supply of naloxone, which is the only way to save someone that’s overdosing. Ideally, though, the White House would declare a state of emergency so we could also use money to increase training and education for medical providers, so they know how to administer and prescribe the antidote.
“The funding that could become available under state of emergency status would have an immediate, more sustained benefit compared to public health emergency status.
“In recent years, there’s been a decrease in federal assistance for treatment facilities. A state of emergency declaration would have better potential to reverse this trend and increase the numbers of beds in treatment facilities. Our communities in rural areas, especially our tribal communities, need help close to home so funding is critical to improving their care.
“Public relations campaigns are welcomed, though it must be followed with additional action. The stigma associated with addiction is debilitating in some cases. When awareness building is taking place and reducing stigma, we need federal officials to fund and engage states in improving access to care. This multifaceted approach is the best approach.
“While state of emergency may not be a silver bullet, it would be more helpful than a public health emergency designation. We know this because previous prevention efforts made possible by much smaller federal drug-free community grants actually reduced rates of substance abuse in towns across Northern Minnesota. Funding is critical to saving more lives.”
Laura Palombi, Pharm.D, MPH, is an assistant professor in the University of Minnesota College of Pharmacy, working directly with communities and healthcare professionals to both prevent and address opioid misuse and improve awareness and access to naloxone.
Katy Kozhimannil, PhD, MPA
“Nonmedical opioid use and opioid dependency among reproductive-age women is a complex public health challenge. In pregnant women, it is associated with increased risk of newborn withdrawal, known as neonatal abstinence syndrome (NAS), and preterm birth, the largest contributor to infant mortality. The good news is that comprehensive treatment, including medication-assisted therapy combined with adequate prenatal care, reduces the risk of obstetric complications for pregnant women with opioid dependency and of NAS.”
“The incidence of maternal opioid abuse and neonatal abstinence syndrome (NAS) increased disproportionately in U.S. rural counties from 2004 to 2013 relative to urban counties. This geographic disparity highlights the urgent need for policymakers to target efforts to improve access to opioid prevention and treatment services for rural women and children. Potential funding priorities may include increasing access to medication-assisted therapies and to culturally centered programs supporting the diverse communities of pregnant women and families affected by opioid use in rural America.”
“Our recent research showed that, among women with nonmedical opioid use, pregnant women were more likely than women who were not pregnant to list a doctor as their source of opioids, suggesting the need for targeted policies to address physician prescribing during pregnancy.”
Katy Kozhimannil, PhD, MPA, associate professor in the University of Minnesota School of Public Health, studies health care delivery, quality, and outcomes for reproductive-age women and their families.
Sarah Gollust, PhD
“Public opinion research I conducted with colleagues from Johns Hopkins Bloomberg School of Public Health demonstrates that majorities of the public believe the problem of opioid abuse is serious and warrants action by the government. Hopefully, this declaration will lead in the short-term to greater adoption of medication-assisted treatment for people with opioid use disorder as well as more availability of naloxone, a drug that can reverse overdoses."
"Key questions for the future will be whether sufficient funds are allocated to address the problem, and whether the Administration adopts a public health-oriented approach or a criminal justice approach to address opioids in the long term. It is also important to recognize the high levels of stigma among the public toward people who abuse opioids. My collaborative research shows that people with more stigma toward opioid users were more likely to support punitive, rather than public health-oriented policies. It is my hope any action on opioids from the Administration helps de-stigmatize this issue and catalyzes genuine and effective prevention efforts."
Sarah Gollust, PhD, associate professor in the University of Minnesota School of Public Health, examines how health information gets translated into the media, shapes public attitudes and opinions, and influences the health policy process.
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