This past week the Centers for Disease Control and Prevention reported that based on preliminary estimates, overall drug overdose deaths in America declined by around 5 percent the first drop since 1990.
This nearly three decade awaited decline was spearheaded by a decrease in deaths from commonly prescribed prescription opioids such as hydrocodone and oxycodone.
This drop produces a long awaited victory in the decades long targeting of prescription drug abuse via both federal and state Prescription Drug Monitoring Programs (PDMP), education, and by holding drug prescribers and manufactures more accountable.
“Lives are being saved, and we’re beginning to win the fight against this crisis,” said Alex M. Azar II, the Secretary of Health and Human Services, but he quickly followed up by stating we have “by no means declared victory against the epidemic or addiction in general.”
The Secretary’s cautiously optimistic view is well placed. Despite a year over year decline, drug overdose deaths for 2018 will still exceed 68,000, and fatalities from deadly drugs like fentanyl are still on the rise.
While a combination of state, Federal and private sector initiatives have helped limit the number of excess opioid prescriptions in circulation, we need to use caution not to over police, over legislate, or engage in political grandstanding when it comes to regulating how these drugs are dispensed.
Just as with the dangers of over policing in crime strategies such as broken windows, we should not force arbitrary dosage limits upon patients who live with chronic pain, or preempt the professional opinion of doctors who are charged with deciding a best course of treatment for their patients.
Systems are now in place to monitor and identify those who abuse prescription drugs by either doctor shopping on the patient end, or over prescribing on the professional end. Over regulating treatment plans forpatients in chronic pain who both need and benefit from the properly applied use of opioids will only drive them towards unrestricted and deadly illicit alternatives.
When it comes to illicit opioids, the data shows we need to expand our efforts to curtail the synthetic drug flow. From 2013 to 2017 seizures of fentanyl at the border increased by 75,000 percent, and the steady rise of overdose deaths in America only proves that much more is successfully getting through. To put things in perspective, only two pounds of fentanyl was seized by Customs and Border Patrol in 2013. This number rose to 1,500 pounds in 2017.
We’ve made strides in determining, documenting, and putting on notice, the major outside suppliers and producers in China and Mexico who provide the pipeline for these substances, and now it’s time to put some teeth behind the talk.
Via the STOP Act, we have closed the loophole where synthetic drug manufacturers in China were utilizing our own postal service as their U.S. taxpayer subsidized discount drug courier. We also increased screening standards and mandated package data, allowing authorities to track foreign drug distributers.
China has adapted to these restrictions and now sends their shipments or drug components to places like Mexico or Canada where they are assembled and smuggled into America.
The Interdict Act, a bipartisan anti-fentanyl legislation signed by the President, has provided $15 million to the US Customs and Border Protection for resources, personnel, scanning devices and technologies to specifically look for synthetic opioids at our ports of entry and mail facilities.
Pending bipartisan legislation S.1044, the Fentanyl Sanctions Act, will give Law Enforcement the tools not unlike the organized crime Racketeer Influenced and Corrupt Organizations Act or RICO, that will go after the banking, assets, and money flow of persons, organizations, or countries that continue to ship their synthetic poison into the United States.
This will hit where it hurts because at the end of the day, this epidemic created by illegal drug trafficking is all about money.
Our progress shows we are headed in the right direction when it comes to ending the opioid epidemic. We must build on the successes made in combating prescription opioid abuse, but not fall into the tunnel vision of over regulation.
We should build on what we’ve learned to target: the existential threat that China and Mexico play as the conduit of the illicit synthetic opioid trade.
The deaths and impacts to the United States are undeniable; the vulnerabilities, trafficking methods, and participants are clear. Unless we add teeth to our words in regards to the opioid epidemic that threatens our public health, this historic drop in overdose deaths may be short lived.
Rob O’Donnell is a retired NYPD Detective and worked for the Department’s Organized Crime Control Bureau Narcotics division.
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