Panel Suggests Bold Opioid-Fighting Measures, Including Lifting Buprenorphine Restrictions

A panel formed by the Association of Schools & Programs of Public Health (ASPPH) is calling for an opioid crisis response resembling the highly successful public health effort against HIV/AIDS, and that would require removing nearly all existing barriers to evidence-based treatment and harm reduction approaches.

The panel's report, released Nov. 1, therefore includes recommendations such as deregulating the prescribing of buprenorphine for opioid use disorder, ending the ban on use of federal funds to purchase syringes for syringe exchange programs, and establishing legal supervised injection facilities in areas of high need.

Experts who are cited in the report, Bringing Science to Bear on Opioids, state that without a comprehensive opioid-fighting response, the annual number of opioid overdose deaths will not experience a continued decline but will hit 82,000 in 2025.

“We believe the task force's recommendations, if implemented and adequately resourced, will help advance the treatment of people currently suffering from opioid use disorder, greatly reduce the number of citizens misusing opioids in the future, and begin to heal communities devastated by the opioid crisis,” said ASPPH board chair Sandro Galea, MD, dean of the Boston University School of Public Health.

The ASPPH late last year assembled the panel to conceptualize a public health-focused approach to the opioid crisis. The foundational principles on which the report's recommendations are based include that the crisis touches all levels of society and must be addressed across sectors, and that corporate and personal greed drove inappropriate use of opioids leading to addiction.

The report suggests that if a master settlement agreement is reached in the far-ranging litigation against opioid manufacturers, funds should be used in part to mitigate associated harms and contain other public health crises with similar causes, such as hepatitis B and C.

Other recommendations in the report include:

• Launching a national anti-stigma campaign against opioid use disorder and its treatment.

• Discontinuing promotion of opioids for long-term use for chronic non-cancer pain, except in cases of palliative and end-of-life care.

• Approving an affordable and accessible form of the overdose reversal drug naloxone available over the counter.

• Using the Ryan White CARE Act as a model for adoption of congressional legislation for a comprehensive public health response to the opioid crisis.