While recognizing that opioid-epidemic reversal strategies that may work in one community may not be transferable elsewhere, successful local programs can still provide lessons and inform the development of treatment and prevention efforts in other communities, according to an AMA Board of Trustees report whose recommendations were adopted at the 2019 AMA Interim Meeting in San Diego.
The report highlights strategies in Huntington, West Virginia, and Clark County, Indiana, and examines whether other communities could use them as examples for their own efforts.
To help address the city’s opioid epidemic, Huntington used a $2 million federal grant to build a multidisciplinary “quick response team” (QRT) that included representatives from law enforcement, a paramedic, a faith-based leader and a health care provider. Data suggest that QRT efforts may help reduce opioid-related harms, according to the report. But the report raises concerns about the sustainability of QRTs in Huntington and elsewhere that use grants to fund their operation.
The effort in Clark County was directed by U.S. Surgeon General and AMA member Jerome Adams, MD, who—in his former role as Indiana state health commissioner—was in charge of the response to an HIV outbreak spread by the use of shared needles. Key to stopping the further spread of the infection was a plan that allowed injection drug users to obtain sterile needles and syringes without a prescription.
The report concludes that effective strategies and initiatives include opioid-overdose teams, needle-exchange programs, wider access to naloxone, and the establishment of drug courts that grant judges more flexibility in cases involving people arrested for an opioid-related crime.
To support the implementation of these and other effective strategies, the House of Delegates directed the AMA to:
- Encourage relevant federal agencies to evaluate and report on outcomes and best practices related to federal grants awarded for the creation of quick response teams and other innovative local strategies to address the opioid epidemic, and share that information with the Federation of Medicine.
- Update model state legislation regarding needle and syringe exchange to state and specialty medical societies.
- Encourage drug courts to rely upon evidence-based models of care for those who the judge or court determine would benefit from intervention rather than incarceration.
- Urge state and federal policymakers to enforce applicable mental health and substance-use disorder parity laws.