Short-sighted: Why the administration’s opioid plan won’t work

Last week, the Trump administration released a five-step plan to address the country’s opioid addiction crisis. The administration’s new drug czar’s plan focuses largely on attempts to prevent opioid-related overdose deaths.

It won’t work. Here’s why: The plan continues a years-old downstream focus on overdose death prevention and neglects the opportunity to prevent addiction in the first place.

In 2023, the last year for which we have full-year overdose data, 81,000 Americans died from an opioid-related overdose — an average of more than 220 deaths per day. Despite these staggering numbers, the administration’s plan primarily focuses on stopping the flow of illicit fentanyl into the U.S., relying on border control and punitive measures against drug cartels.

While addressing fentanyl trafficking is important, this approach tackles only one part of a far more complex problem. The reality is that overdose deaths remain high not only because of illegal fentanyl but also because millions of Americans continue to receive prescription opioids to manage postsurgical pain, whether they need them or not. In fact, as many as 90 percent of all surgical patients in the U.S. today receive an opioid prescription for post-operative pain.

The administration’s approach also touts increasing access to naloxone and medication-assisted treatment for opioid-use disorder, which are essential components of addiction treatment and overdose prevention. However, these measures are reactive, not proactive. They miss an important opportunity to prevent addiction before it starts by expanding non-opioid pain management options.

Current pain treatment protocols incentivize the use of generic prescription opioids. They do so because such medicines are cheap and well-known to health care professionals, and most patients will tolerate these medicines without incident.

However, some —  estimates show between 6 percent and 20 percent —  will misuse these medicines. Some may become addicted and move on to other illicit forms of opioids. Some will overdose. Some will die.

This overreliance on prescription opioids strips patients of real choices and unnecessarily increases the risk of long-term dependency. We have the tools to change the status quo.

We must change how we treat pain in this country and ensure that patients and health care providers have options when it comes to treating acute pain. The passage of the Non-Opioids Prevent Addiction in the Nation Act in 2022 was a major step forward, ensuring that non-opioid alternatives are available in outpatient surgical settings.

But there is more work to do.

We must ensure that all patients in all settings can easily access non-addictive pain treatment options. This is especially true for patients covered by Medicare Part D plans.

Earlier this year, legislation was introduced in Congress called the Alternatives to Prevent Addiction in the Nation Act. This critical legislation would make sure that patients can easily access non-opioid medications at the pharmacy counter.

The opioid addiction epidemic is far from over. Hundreds of Americans still die every day, and the crisis is evolving in ways that demand urgent action. Focusing solely on border control and fentanyl supply reduction ignores the deeper issue: how we manage pain in our health care system.

If we are serious about preventing addiction and saving lives, we must prioritize non-opioid choices — before it’s too late.

Every day we delay action, more patients are denied access to a non-opioid pain management tool. Recently, a major insurance company announced that it was making it more difficult for Americans to access non-opioids. We cannot stand idly by and let this happen.

This proposal would ensure that all patients can access non-opioid treatments in all settings. It can prevent addiction before it starts.

Congress has a chance to get ahead of this crisis — but only if they act now. Passing the act is a concrete step toward ensuring that patients have real choices in pain management. If we are serious about preventing addiction and saving lives, we must prioritize non-opioid choices.

We cannot afford to fight the opioid crisis with half measures.

Chris Fox is executive director of Voices for Non-Opioid Choices.