13th annual Municipal Finance Conference


13th annual Municipal Finance Conference


Un-burying the lead: Public health tools are the key to beating the opioid epidemic

The opioid crisis claims 175 lives daily. In addition to these deaths, other tragic and costly health consequences of this epidemic include unprecedented increases in the incidence and prevalence of addiction, increased hospitalizations and emergency room visits, and a dramatic increase in the number of babies born with neonatal abstinence syndrome.

On November 1, the President’s Commission on Combating Drug Addiction and the Opioid Crisis released its recommendations for fighting this crisis. The report proposes a number of measures that would make systemic changes with the potential for long-term impact. However, these recommendations will have limited success unless policy-makers prioritize the public health recommendations from the report, and implement them with immediate action steps.

In “Un-burying the lead: Public health tools are the key to beating the opioid epidemic” (PDF), Brookings nonresident senior fellow Dayna Bowen Matthew looks at the report’s recommendations and draws parallels between today’s crisis and other historic drug epidemics, to examine the public health lessons policymakers can learn. She argues for a more equitable approach to America’s past and present drug crises. Although the victims of today’s opioid crisis are largely white, while the heroin crisis of the 1970’s predominately affected communities of color, we should look beyond race to see the similarities these epidemics share. The social risk factors that contribute to both these crises counsel similar policy solutions.

Matthew then suggests a number of ways policymakers can build on the report’s recommendations to address issues of housing and employment, community engagement, and criminal justice interventions that are essential to defeating the worsening opioid crisis.

Among the six recommend next steps to address these social determinants of the opioid crisis, Matthew suggests policymakers:

  1. Utilize Medicaid to reimburse supportive housing programs that co-locate employment, education, and health services.
  2. Promote and finance two-generation, family-centered treatment and support for children under foster and kinship care.
  3. Involve community leaders in designing preventive systems for younger children to promote healthy behaviors, social skills, community opportunities, and pro-social involvement.
  4. Broaden public health-based approaches to re-build workforce capacity among victims of past drug epidemics.
  5. Extend the benefits of public health-based interventions to individuals who were burdened by criminal justice rather than public health approaches to the disease of addiction during America’s earlier opioid crisis.
  6. Strengthen supports for public housing providers to avoid eviction when residents are amenable to treatment for opioid addiction.

Ultimately, Matthew concludes that focusing solely on reducing the supply of opioids or on providing treatment for those affected by the epidemic will only address one part of the crisis.

“The key to a successful battle against opioid addiction will be prioritizing interventions aimed squarely at the environmental risk factors in order to address true impacts that social determinants have on opioid dependent populations, while also continuing efforts begun to address prevention and treatment aimed at the supply side and continuum of care.”

Read the full report here.

The author did not receive financial support from any firm or person for this article or from any firm or person with a financial or political interest in this article. She is currently not an officer, director, or board member of any organization with an interest in this article.