Mitigating the opioid addictions crisis and preventing future epidemics requires crafting effective policy at both the state and federal level. Researchers at Indiana University have released a series of research-driven public policy recommendations as part of an in-depth analysis of the opioid epidemic. The report, Legal and Policy Best Practices in Response to the Substance Abuse Crisis, is one element of the University’s Responding to the Addictions Crisis Grand Challenge initiative.
What Matters Most?
The report calls for more and better treatment options and the expansion of “wraparound services” like job training or safe housing assistance that help support those recovering from substance use disorder (SUD). Also highlighted is the need for a broader and more clearly-defined Good Samaritan law that would encourage protected reporting of drug-related emergencies. These recommendations, among others, offer local, state and federal governments an array of tactics for mitigating the opioid addictions crisis facing communities across the nation. The report is based on original research, including interviews with twenty individuals with expertise on the addictions crisis at the state, local, and national level.
The report provides more than twenty recommendations across eight broad subject matter categories. A full listing of the recommendations can be found in the public policy report; some examples are listed below:
- Harm Reduction: Harm reduction measures are public health interventions that seek to minimize illness and injuries associated with drug use, rather than seeking to reduce the incidence of drug use. Key changes could include updated overdose immunity laws, drug paraphernalia laws, and safe stations.
- Healthcare Interventions: In spite of recent progress, real or perceived barriers to effective interventions remain, including: challenges to syringe exchange programs, administrative barriers to Medicaid services, access to and cost of treatment, and availability of treatment and post-treatment services.
- Care Coordination and Wraparound Services: In addition to the provision of more and better treatment options and the expansion of “wraparound services,” the transition of patients with SUD between treatment providers or, for those re-entering society, between corrections and Medicaid providers. Providing such care coordination will reduce costs and improve care.
- Drug Take Back Programs: Programs promoting secure storage and disposal of prescription opioids, including the drug take back programs, are an important means through which to reduce the diversion and misuse of prescription drugs. Local initiatives should also be encouraged.
- Patient Privacy Protections: The lack of alignment between the federal privacy protections relating to medical records generally and those applying to substance use records is a serious legal barrier. Health and human services agencies should coordinate their work and provide guidance for providers, health information exchanges, and patients.
- Courts: SUD is prevalent in the criminal court systems. The Sequential Intercept Model is recommended as a framework to boost SUD services and move the management of mental health and SUD concerns outside the traditional criminal justice system and into specialized court systems or health care and support services in the community.
- Proceeds from Opioids Litigation: Hundreds of lawsuits have been filed against prescription opioid manufacturers and other participants in the drug supply chain across federal and state courts. The plaintiffs have begun to calculate the economic losses to their communities and settlement negotiations are ongoing. It is important to ensure that the damages collected will go to improving addictions education, healthcare, and wraparound services for the victims of the epidemic, and services for children born with Neonatal Abstinence Syndrome.
- Stigma: Issues related to mental health and SUD have been stigmatized by society. Education campaigns about SUD, medication assisted treatment and naloxone would be valuable to both providers and the public. State and local policy groups; community coalitions; and programs related to SUD treatment, care and response should include the voices of those directly impacted by SUD, including family members and current or former SUD service recipients whenever possible.
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Nicolas Terry, Hall Render Professor of Law, Executive Director of the William S. and Christine S. Hall Center for Law and Health; Ross Silverman, Professor of Health Policy & Management, IU Richard M. Fairbanks School of Public Health at IUPUI; and Aila Hoss, Visiting Assistant Professor and IU Grand Challenges Fellow, IU Robert H. McKinney School of Law.