2022 North American Commission Report Addresses the Opioid Epidemic

2022 North American Commission Report Addresses the Opioid Epidemic

The current COVID pandemic, by all measures, has had a devastating effect on countless lives around the world. However, another epidemic is continuing to wreak havoc here in the U.S. and Canada. According to the Stanford-Lancet Commission on the North American Opioid Crisis (“the Commission”), there have been over 600,000 U.S. and Canadian fatalities due to an opioid overdose, and it’s estimated by 2029 there will be more than 1.2 million opioid-related deaths in these two countries.[1] Given these alarming statistics, the need for solutions to “the opioid epidemic” are greater than ever.

The Commission, supported by Stanford University, was comprised of a wide-ranging group of scholars and experts in the field of addiction from all over the U.S. and Canada. In its seeking to develop a coherent, empirically grounded analysis of the opioid epidemic, the Commission’s stated goals were to:

• Understand the opioid crisis;
• Propose solutions to the crisis domestically; and,
• Attempt to stop its spread internationally.[2]

Per the Commission’s findings (published in The Lancet on Feb. 2, 2022), North America’s opioid epidemic arose “when insufficient regulation of the pharmaceutical and health-care industries enabled a profit-driven quadrupling of opioid prescribing.”[3] The significantly increased prescribing of powerful opioids for a broad array of chronic pain conditions eventually resulted in hundreds of thousands of people dying of overdoses, while millions more have either addicted to or have been harmed by opioids (either by their own opioid use or someone else’s — including unemployment, disability, family disintegration, criminal activities and consequences).

In addition, the problems associated with the explosion of opioid abuse and dependency fueled the expansion of heroin sales, only furthering the rising rates of addiction and overdose deaths. A truly widescale public health emergency arose—and has only multiplied over the past two decades—as both heroin and opioids like fentanyl began saturating the landscape, from major metropolitan areas to small rural towns and everything in between.

What solutions does the Commission propose? Here is a brief summary of their recommendations:

1. Build integrated, well supported, and enduring systems of care for people with substance use disorders;
2. Maximize the benefits and minimizing the adverse effects of the involvement of the criminal justice system with people who are addicted to opioids;
3. Create healthy environments that can yield long-term declines in the incidence of addiction;
4. Stimulate greater innovation in the response to the opioid crisis; and,
5. Prevent the North American opioid crisis from spreading globally.

Emphasizing the use of evidence-based policies, the Commission’s report goes on to advocate for increasing access to high-quality, non-stigmatizing, integrated health and social care services for people with opioid use disorders. According to the Commission, this recommendation can, at least in part, be funded by existing healthcare support systems and by holding both public and private healthcare insurance providers to greater levels of responsibility for addressing opioid-related health issues. This includes their backing of effective and established models of chronic pain management that give priority to safety (with increased scrutiny of guidelines for prescribing opioids for pain) and increasing access to addiction treatment and recovery support whenever shown to be necessary.

The report also calls for a large and long-term investment in: a) increasing the addiction-related knowledge and skills of physicians, and b) boosting the number of addiction specialists in both the U.S. and Canada. In addition, it calls for all relevant justice systems to provide addiction treatment and other health services during incarceration, as well as supporting youth-oriented prevention programs aimed at building up core capacities and decreasing the risks of not just drug use, but also mental health issues (e.g., anxiety and depression), obesity and poor academic performance. One further proposal is to restrict or outlaw youth-targeted advertising of addictive drugs, including tobacco products and alcohol.

While much of the Commission’s report focuses on solutions, it does include a cautionary quote from Patrick Keefe’s New York Times bestselling book, Empire of Pain: “The opioid crisis is, among other things, a parable about the awesome capability of private industry to subvert public institutions.”[4]

In conclusion, the Commission points hopefully to a future empowered by its report findings: “It took more than a generation of mistakes to create the North American opioid crisis. It might take a generation of wiser policies to resolve it. Such policies will have long-lasting gains if they curtail the power of health-care systems to cause addiction and maximize their ability to treat it.”[5]

[1] Stanford-Lancet Commission on the North American Opioid Crisis. February 2022.
[2] Ibid.
[3] Ibid.
[4] Keefe, P.R. Empire of Pain: The Secret History of the Sackler Dynasty. Doubleday. Apr. 2021.

[5] Stanford-Lancet Commission on the North American Opioid Crisis. February 2022.