A Public Health Strategy for the Opioid Crisis

Bibliographic Data

ID23326880
AuthorsBrendan Saloner (0000-0001-9013-3023, Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA, corresponding author), Emma E Mcginty (0009-0003-5095-9308, Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA), Leo Beletsky (0000-0003-0726-0676, Northeastern University), Ricky N Bluthenthal (0000-0003-3491-1702, University of Southern California), Ricky Bluthenthal (University of Southern California), Chris Beyrer (0000-0003-0665-9124, Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA), Michael Botticelli (Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA), Susan G Sherman (0000-0001-8399-7544, Department of Health, Behavior, and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA)
Year2018
Volume133
Issue1_suppl
Pages24S-34S
Publication date2018-11-01
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenuePublic Health Reports (JOURNAL)
Journal identifiersISSN: 0033-3549 • E-ISSN: 1468-2877
PublisherSAGE Publications (PUBLISHER • US)
DOI10.1177/0033354918793627
PMID30426871
OpenAlexW2901809553
LanguageEN
Citations received53
References cited75

Drug overdose is now the leading cause of injury death in the United States. Most overdose fatalities involve opioids, which include prescription medication, heroin, and illicit fentanyl. Current data reveal that the overdose crisis affects all demographic groups and that overdose rates are now rising most rapidly among African Americans. We provide a public health perspective that can be used to mobilize a comprehensive local, state, and national response to the opioid crisis. We argue that framing the crisis from a public health perspective requires considering the interaction of multiple determinants, including structural factors (eg, poverty and racism), the inadequate management of pain, and poor access to addiction treatment and harm-reduction services (eg, syringe services). We propose a novel ecological framework for harmful opioid use that provides multiple recommendations to improve public health and clinical practice, including improved data collection to guide resource allocation, steps to increase safer prescribing, stigma-reduction campaigns, increased spending on harm reduction and treatment, criminal justice policy reform, and regulatory changes related to controlled substances. Focusing on these opportunities provides the greatest chance of making a measured and sustained impact on overdose and related harms.

Addiction · Drug · Drug overdose · Environmental health · Harm reduction · Heroin · Methadone · Opioid · Opioid overdose · Poison control · Psychiatry · Public health · HIV, Drug Use, Sexual Risk · Medicine · Nursing · Opioid Use Disorder Treatment · Prenatal Substance Exposure Effects

Tools

Open DOISci-HubOpen Access