A Combination of Approaches Helps Local Governments Tackle the Opioid Crisis

The Pew Charitable Trusts

By The Pew Charitable Trusts staff

The Pew Charitable Trusts recently hosted a panel discussion in Philadelphia on how the city and other urban areas, such as Baltimore and Staten Island, New York, are responding to the opioid crisis. Focusing on the latest evidence-based strategies for improving treatment and prevention, the April 20 event highlighted innovative, multifaceted responses that have been successful in all three jurisdictions and elsewhere.

Here are nine policies and practices highlighted by the panelists—Evan Behrle, special adviser on opioid policy for the Baltimore City Health Department; Dr. Thomas Farley, Philadelphia’s health commissioner; Michael McMahon, district attorney of Richmond County, representing the New York City borough of Staten Island; and Cynthia Reilly, director of Pew’s substance use prevention and treatment initiative.

Expand the use of naloxone to prevent overdose deaths. Naloxone is a prescription drug that can save lives by reversing the effects of an opioid overdose. It is available to anyone in Pennsylvania, New York, Maryland, and most other states at any pharmacy, without a prescription. But price is an issue: Narcan, the most popular brand of naloxone, costs $150 per dose, although it is covered by most insurance plans with a $40 copay. Behrle pointed out that generic versions of naloxone are far less expensive in other countries.

Push for fewer opioid prescriptions, while maintaining effective pain management. Physicians and other health care providers legally prescribe opioids to manage patients’ pain. In some instances, such prescriptions can lead to misuse and dependence. While reports indicate that opioids are now being prescribed less often, the panelists agreed that further reductions would be beneficial. Philadelphia, Baltimore, and New York City have sued the pharmaceutical companies that manufacture and distribute opioids, saying the companies overstated the benefits and understated the risks of prescribing the drugs.

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