To combat opioid crisis, we need to take a different approach

Last week, Reps. French Hill (R-Ark.) and Debbie Dingell (D-Mich.) wrote about legislation they’re championing to address the nation’s opioid epidemic. The Preventing Overdoses and Saving Lives Act 2.0 would require co-prescribing opioid overdose reversal drugs alongside prescriptions for opioid-based painkillers.  

While I applaud the members’ attention to this dire and worsening public health crisis, and with all due respect to the members of Congress, we have tried this type of approach before. Many times. And it hasn’t worked. 

In the last decade, Congress has dedicated hundreds of millions of taxpayer dollars toward combatting the opioid epidemic. Money that has gone to support first responders, increase access to treatment for substance use disorder, and ensure widespread availability of naloxone. Yet here we are — with record-breaking numbers of Americans dying every year from an opioid-related drug overdose.  

Last year, the CDC reported that approximately 107,000 Americans died of a drug overdose. Three-quarters of these deaths involved opioids. All told, we lost 220 Americans every day from an opioid-related drug overdose in 2021. This represents a 90 percent increase since 2018. Clearly, this problem is getting worse before it’s getting better. 

It’s time to try something different.   

For many, the path to addiction starts innocently enough — including after undergoing a routine surgical procedure. Ninety percent of surgery patients are prescribed opioids to manage their pain and, of these, four million will initiate long-term opioid use following such procedures. 

Focusing on access to overdose reversal drugs — while important — perpetuates opioids as the standard of care for treating postoperative pain. Such an approach misses the opportunity to prevent substance use. One way to accomplish this would be to minimize unnecessary exposure to opioids for surgical patients. This is particularly important for younger, opioid-naïve patients.  

We must do more to prevent opioid use disorder, including increasing access to safe, effective, and non-addictive pain management options. Unfortunately, current Medicare reimbursement policies continue to incentivize the use of opioids to treat postsurgical pain. This approach puts a non-opioid pain management option out of reach for tens of millions of surgery patients every year. 

Pending federal legislation would address this issue. The Non-Opioids Prevent Addiction in the Nation (NOPAIN) Act (HR 3259 / S 586) would update Medicare reimbursement policy to incentivize the use of FDA-approved non-opioid pain management options. The legislation would increase access to and use of FDA-approved non-opioid pain management options. In the process, the legislation would prevent individuals from developing an opioid use disorder and, ultimately, save lives. 

This legislation would deliver patients, providers, and caregivers options for treating postsurgical pain. And, with fewer patients being exposed to prescription opioids, fewer Americans will initiate a long-term opioid use habit. If we can prevent individuals from misusing opioids, we can save lives. It’s that simple.  

The NOPAIN Act is gaining momentum on Capitol Hill. The legislation is supported by more than 150 members of Congress, including nearly half of the Senate. I urge Congress to take a different approach to the opioid epidemic ravaging our communities. Let’s try preventing opioid addiction before it starts and pass this critical legislation. American lives hang in the balance. 

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