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On Oct. 26, the president declared the nation’s opioid crisis a public health emergency. In choosing not to declare the opioid epidemic a national emergency, the president prevented states from accessing the federal Disaster Relief Fund for prevention and treatment efforts.  The president outlined his administration’s plans to prevent opioid overdoses  — including improvements to prescribing guidelines, substance abuse campaigns and the use of law enforcement — but according to public health leaders, his plans fall short of the comprehensive effort that is needed to fully address the crisis.

Opioid prescribing guidelines

In his remarks, the president said that the U.S. Department of Health and Human Services will “launch a taskforce to develop and update best practices for pain management across the federal government.” Centers for Disease Control and Prevention has already taken steps to revise opioid prescribing guidelines, releasing its most updated guidelines in March 2016. But research from Boston University shows that best practices can also be improved by educating clinicians about opioid use and improving adherence to prescribing guidelines.

At a Senate briefing titled, “Intersection of substance abuse, injury and violence,” director of the National Center for Injury Prevention and Control, Deborah Houry noted that CDC is working with medical and nursing schools to include curricula on the addictive nature of opioids and how to safely prescribe them. A comprehensive plan to beat back the opioid crisis would expand these efforts and provide workshops and educational tools for clinicians.

Substance abuse campaigns

The president said his administration will also fund advertising campaigns encouraging people not to “take drugs in the first place because they will see the devastation and the ruination it causes to people and people’s lives.”

Studies indicate that many anti-drug and substance abuse campaigns and programs that focus on drug education and instruct youth not to take drugs are ineffective and do not change youth behavior. Studies on alcohol use reviewed by researchers from the University of Texas  suggest that effective interventions should help young people develop social skills to resist pressure to use drugs and use interactive teaching methods that engage students. Research from Pennsylvania State University suggests that it is also important to develop interventions based on cultural contexts, and integrate all parts of a community into prevention efforts.

Federal government action could provide funding for these interventions and more to stem the demand for opioids and prevent drug use.

Law enforcement

The president’s remarks defined law enforcement’s role in stopping the crisis as twofold: curbing the importation of fentanyl, a synthetic opioid often trafficked into the U.S., and supporting programs to help people facing addiction.

Yet research from Yale University suggests that law enforcement can effectively play an expanded role in preventing deaths due to overdose. Educating law enforcement on strategies to deal with overdose cases and equipping them with naloxone can help reduce the number of opioid-related mortalities.

Several states have already implemented policies that allow law enforcement — as well as emergency medical services personnel and firefighters — to administer opioid antagonists like naloxone in cases of overdoses related to opioids. The federal government can encourage all states to pass such policies and expand coverage and funding for naloxone.

Public health research shows that the administration can develop a fuller and more comprehensive plan to prevent opioid use and overdose. A plan to stop the opioid crisis that embraces these public health policies would require an investment in opioid prevention that the president’s current plan fails to provide. The American Public Health Association will continue to call on the president and his administration to work with Congress through bipartisan efforts to make adequate funding available and implement proven evidence-based strategies to end this crisis.