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Current Efforts in Drug Overdose Prevention: Progress and Challenges

posted on Thu, Jul 17 2014 12:15 pm by Corey Davis

On June 19, I attended the Office of National Drug Control Policy’s (ONDCP) Summit on Heroin and Prescription Drug Abuse, which convened public health and government leaders to discuss the current epidemic of opioid drug abuse, and identify practices and models to help reduce overdose deaths and public health consequences. According to the Centers for Disease Control and Prevention, overdose deaths from prescription opioids such as oxycodone and hydrocodone  more than quadrupled from 1999 to 2010. As physicians, policy makers, advocates and others shared their insights and experiences at the summit, it was clear that opioid overdose is a public health crisis in communities across the nation.

The ONDCP recently released its 2014 National Drug Control Strategy, and I was gratified to see an emphasis on overdose prevention through evidence-based public health approaches.

Earlier in May, the Network together with ChangeLab Solutions and the CDC National Center for Injury Prevention and Control, conducted a half-day training workshop on legal and policy approaches to reducing prescription drug overdose. The training, which was held prior to the Safe States Alliance’s annual meeting, focused on two approaches states have used to address the overdose epidemic: (1) Prescription Drug Monitoring Program (PMPs), and (2) Legal changes that increase access to emergency care and treatment for opiate overdose, including the administration of naloxone. We talked about the evidence base for these interventions, shared best practices, and discussed with the attendees ways that they can help improve law and policy in their states.

I always learn something from the dedicated people who participate in these trainings, and this was no exception. We’ll have more information about the training session soon (including slides and a facilitator’s guide), but I wanted to quickly share some of the things that I took away from the session.

First, participants noted that they’re often unclear as to the scope of overdose prevention laws in their state, and are often unable to get clarity from state or local legal counsel. This appears to be particularly true regarding areas where the laws aren’t entirely clear, such as in states where third-party naloxone prescription is implied but not explicitly permitted.

Second, participants identified an interesting data privacy issue. While much of the legal and policy work in the area of PMP data privacy involves ensuring data confidentiality, several attendees voiced a different concern: lack of access to identifiable PMP data to further epidemiological investigation, and in some cases lack of access to de-identified data for surveillance purposes. In some states this is a problem with the way the law is written, but in many others it seems to be a translational problem, where the agency in charge of the PMP adopts a data access policy more restrictive than what the statute requires.

Finally, a number of participants suggested that medical amnesty laws (often called Good Samaritan laws) are often difficult to explain and are likely not sufficient to change behavior (for example, laws that provide protection only from prosecution for small amounts of drugs). Model laws or checklists of best practices were identified as a tool for improving future and existing laws at the state level. There actually is a naloxone access model law, but so far there isn’t one for Good Samaritan laws.

Again, more on this shortly. But I’d love to hear from folks working in the field as to whether you’re running into any of these issues as well. And of course please view our fact sheets, trainings, and related materials, and feel free to contact us with specific questions as well.

For those planning to attend the Public Health Law Conference in October, this session on legal approaches to reduce drug overdose may be of interest.

Whether online or in person, it is immensely helpful to hear from you as we continue to identify strategies to address drug overdose.

This information was developed by Corey Davis, Deputy Director, the Network for Public Health Law – Southeastern Region at National Health Law Program.

The Network for Public Health Law provides information and technical assistance on issues related to public health. The legal information and assistance provided in this document does not constitute legal advice or legal representation. For legal advice, readers should consult a lawyer in their state

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