By Troy Christensen
Executive Director of the Korean Women’s Association
Innovation around opioid abuse prevention is happening in Washington state, and the Korean Women’s Association (KWA) is collaborating with partners in the regional “Accountable Community of Health” to find solutions to one of the most pressing healthcare equity issues of our time. There isn’t a silver bullet policy that will solve the opioid problem, as the impact to families ranges across a broad spectrum of socio-economic issues. At KWA, we champion strategies that reduce harm to affected individuals. In doing so, we hope to re-orient the public conversation to address the problem for what it is — a public health crisis that requires exceptional resources to unravel.
Recently, Congress approved additional funding to address opioid-related impacts in communities across the country, and we’re in a rare moment where elected officials like Senator Patty Murray are thinking through how best to deploy federal resources to achieve that end. In our view, additional funding should be invested in tactics that create capacity for harm reduction when it matters most.
Reducing harm, first and foremost, means saving lives. In addition to the emotional distress and family impact, the death of a father, mother, son, or daughter through overdose often deprives a family of a household income-earner and provider, a devastating loss that ripples across generations.
One solution to preventing the loss of life could be requiring the co-prescription of naloxone, the opioid overdose antidote, to at-risk patients. Data from past years published by the Centers for Disease Control and Prevention have reported that as much as 83 percent of prescription opioid overdose deaths are unintentional.
Medicare and Medicaid patients are particularly at-risk. In 2014, over half of opioid-related visits to hospitals were paid for by Medicare or Medicaid. A 2016 Centers for Medicare & Medicaid Services study in Washington state found that 45 percent of people who died from prescription opioid overdose were Medicaid enrollees.
Naloxone, when prescribed to at-risk populations, has been proven to significantly lower rates of emergency hospital visits and opioid overdose deaths. A National Institutes of Health study found that patients who received a naloxone prescription had 47 percent fewer opioid-related emergency department visits per month in the 6 months of receipt after the prescription. This same patient population had 63 percent fewer visits after one year, compared to those who were not given a naloxone co-prescription. The Food and Drug Administration has reported equally promising results during a study conducted in partnership with the Veterans Administration.
Why is this the case? First, there’s an extreme imbalance between the number of opioid prescriptions in this country when compared to the number of overdose antidote prescriptions. Currently, for every one prescription of naloxone in the United States, there are 500 opioid prescriptions.
Second, there’s been an unconscionable gap in education with opioid prescribed patients about the dangers posed by their prescriptions. Given the vast majority of opioid prescription deaths are unintentional, the more mandatory conversations we can require between doctors, pharmacists, and patients, the better people will be equipped to manage their prescriptions without incident.
Requiring co-prescription of naloxone to at-risk patients isn’t the sole solution for the broader set of issues brought to bear by the opioid addiction crisis. A range of wrap-around support services will also be needed to address other social maladies that challenge our communities. But as lawmakers contemplate how to address the opioid epidemic in Washington state, they should prioritize investments that are proven to save lives.