Combine the growing popularity of fentanyl with a pandemic that has forced people to isolate, while stripping them of direct relationships and the support systems they depend on, and it’s easy to understand the sudden increase in popularity. variable in the number of drug overdose deaths since the lockdown began.
To tackle the opioid crisis, Wen said, we must refocus on a single mission and remind ourselves that when it comes to public health, we are all striving for the same results: save.
The following interview has been edited for length and clarity.
CNN: Experts have attributed the recent spike in drug overdose deaths to the pandemic and the rise of fentanyl. Can you explain how those two factors affect overdose mortality?
And then the pandemic happened. Public health resources have been stretched to the limit, so those working on the opioid crisis must shift their focus to tackling the pandemic. This is necessary, but it also leaves a hole in the social safety net.
Above all, we know that addiction is a disease of isolation and that recovery depends on relationships. Many people during the pandemic have lost health insurance and the ability to receive treatment. Some may have lost other social resources such as stable housing or face food insecurity. Treatment for their addiction may not be of primary importance. Nor can we forget that addiction and mental health problems are diseases of despair, and that this pandemic has worsened the mental health of so many people. I think it’s another layering component of what was a huge problem that has lost attention and lost funding and lost people working to solve it.
CNN: How to deal with drug overdose deaths while the pandemic is still ongoing and resources are limited?
CNN: What about possible more permanent solutions?
CNN: What are some of the barriers to implementing the policies and initiatives you just described?
Hi beauty: For the most part, thankfully, there is bipartisan consensus that this is a matter of urgency and priority. There are partisan differences around a number of key factors – criminalizing drug use, for example. Many of us in the public health arena would say that addiction is seen as a disease rather than a crime that has passed.
The harm reduction methods I mentioned earlier are also not widely accepted by policymakers at this time. Most people of different political ideologies would support naloxone, because it’s hard to resist the idea that if someone overdoses in front of you, you should save their life. But syringe exchange programs, often naloxone dispensing sites, are controversial. Many parts of the country still don’t allow them for fear they condone drug use, when what they’re really doing is stopping the transmission of HIV and hepatitis, and reaching people who may be able to. prone to overdose.
Also, there’s a big problem surrounding treatment. The concern here is not even so much politics as in partisan divisions, but politics as the resources we are willing to devote to this issue. There are solutions that we can exploit, but do we have the political will to devote the resources to ultimately resolving this crisis?
I understand that there are multiple funding priorities before the Biden administration and before Congress. The question is: where is addiction on their priority list?
CNN: As Baltimore’s health commissioner, you’ve been very focused on implementing specific measures such as broad access to naloxone and increasing access to treatment as part of your initiative to against the opioid crisis in the city. Do you think it is possible to launch a similar initiative on a national scale or does this require separate, local approaches?
CNN: Do you see this as an issue that needs to be addressed primarily at the federal, state, or local government level?
Hi beauty: It needs to be a combination. Funding must come from the federal government and must then be distributed to communities based on need. Then, communities are best positioned to understand how to use that funding for specific programs or resources in their area.
However, the federal government won’t give the money and say, “Do whatever you want with it.” There are very clear instructions on how to spend that money. And in this regard, the federal government has a key role to play in determining what evidence-based disposition the funds may be used for. For example, we don’t want federal money spent on rapid detox programs, which can be harmful and increase overdose rates.
At the same time, the states must do their part. Those who have not yet expanded Medicaid need to do so. We need to have the same addiction treatment policies as for all other medical illnesses.
CNN: What advice would you give to people who are facing addiction and don’t know how to seek help or what resources are available to them?
CNN: Are you optimistic that we will be able to turn this trend around?
Hi beauty: Public health is now at the edge of an ideological and cultural war in a way that it shouldn’t. It doesn’t help that masks and vaccinations are seen as political issues, and public health is now largely equated with Covid-19. So if Covid-19 is seen as a partisan issue, public health by default becomes partisan as well.
Fighting drug deaths is one of those issues where there’s very clear bipartisan agreement that we have a problem, unlike the Covid-19 problem. Not everyone agrees that Covid is even a crisis. Addressing the opioid crisis is one way to regain a bipartisan consensus on public health.
I’m not saying that’s why we should tackle the overdose crisis. We should tackle it because it killed more than 100,000 people in the US last year; we should deal with it because it was a pre-pandemic crisis and then it was largely forgotten.
As an added benefit, however, addressing the opioid crisis can bring us back to the heart of the issue: how public health can unite rather than divide.