Nationwide, states and communities continue to wrestle with the devastating effects caused by the opioid abuse crisis. Both the public and private sector are battling this growing and evolving epidemic on many fronts, often using reactionary, siloed solutions to combat the problem. Here, we call for new, holistic approaches to helping address the opioid crisis and offer insight into innovative solutions which are transforming the battle against opioid abuse. In this series, we offer insight into the approaches both public and private organizations can take together to help combat this collective crisis.
National and state initiatives are vital, but it’s local communities that are experiencing firsthand the human and economic costs of untreated mental and substance use disorders (SUDs). As mentioned in part 3 of our series, Private Sector Perspective, we cannot rely on governments and community agencies alone to fix the opioid epidemic. As stated by Admiral Brett Giroir, Assistant Secretary for Health and Senior Advisor for Mental Health and Opioid Policy for the U.S. Department of Health and Human Services, “It is clear that no single institution can solve the opioid crisis alone. The only viable approach to addressing the opioid misuse epidemic, the most pressing health challenge of our time, is through multi-sector collaboration and a patient-centered approach.” What are the mechanisms the public and private sector can use to collaborate more effectively.
Public-Private Partnership (PPP) Collaboratives
Creating or engaging in Public-Private Partnership (PPP) collaboratives to address the opioid crisis may be our best bet to holistically treat the epidemic. PPPs bring together government (state, federal, agency) and private sector organizations to expand access to higher quality health initiatives by leveraging capital, resource capacity, and expertise. Specifically, they create opportunities for:
- Sharing knowledge and skills across public and private parties
- Increasing our country’s competitiveness
- Analyzing evidence-based outcomes across many sectors
- Developing local private sector capabilities through joint ventures with large international firms
- Timely alignment to initiatives and more easily addressing complex challenges
- Influx of private dollars strengthening public organizations
- Faster response time when leveraging private sector’s technology
- Sharing important population health data across parties
The President’s Commission on Combating Drug Addiction and the Opioid Crisis has met several times to obtain recommendations from physicians and leaders in science and medicine to deal with the opioid epidemic in the U.S. They built a PPP between researchers in academia, industry, and the government. Through effective collaboration, they have reduced the time to make new, non-addictive medications for pain. This would not be possible if the participants in the coalition were not willing to share data to reduce the time necessary to develop effective non-addictive opioid alternatives. It is imperative to gain buy-in and ensure cooperation among all parties or the partnership will be largely ineffective.
Currently, The Federation of State Medical Boards (FSMB) has joined a National Action Collaborative to counter the opioid epidemic. The FSMB is partnering with the National Academy of Medicine (NAM) and 35 organizations for the Action Collaborative on Countering the U.S. Opioid Epidemic. The PPP is made up of organizations representing federal, state, and local governments, health systems, associations/provider groups, health education/accreditation institutions, pharmacies, payors, industry, nonprofits, and academia. The President’s Council of Economic Advisers stated the opioid crisis cost $504 billion in 2015 (2.8% GDP). The collaborative will focus on, but is not limited to the following areas:
- Over-prescription of opioids for treatment of pain – requires involvement of clinicians, researchers, and regulators.
- Inadequate provider education and training – requires educators, accreditation institutions, etc.
- Under-treatment of Opioid Use Disorders – requires industry innovation and policy maker collaboration.
PPPs can work, and it is imperative someone in a leadership position is behind the overall effort to advocate for the strategy and push the narrative – a key factor in facilitating the partnership and obtaining resources and commitment. This individual may be a leader in the federal, regional, state, or local government, non-profit, or private companies. For example, earlier in the year, President Trump called for new steps to combat the opioid epidemic. These steps included reducing opioid prescriptions, requesting more stringent drug trafficking penalties, and expanding support of overdose-reversal medications. Now, President Trump has requested the Attorney General pursue lawsuits against the opioid makers.
Recovery Oriented System of Care
Another way the public and private organizations can work together to address the epidemic is through a Recovery Oriented System of Care (ROSC) where the following work together to make data-driven, integrated, scalable, flexible, and sustainable solutions:
- ServiceProviders: Community Based Organizations (transportation, housing, job support, food), SUD Recovery and Treatment Providers, Behavioral Treatment Providers
- Funding Sources: Medicare, Commercial, Medicaid
- Referral Services: Law Enforcement, Hospitals & Physician Offices, Emergency Medical Services, Opioid Hotline
These solutions require building individuals into a support network among their community to increase success of reintegration and long-term recovery. The Federal Emergency Management Agency (FEMA), has been working to build platforms for state and local officials and private sector partners to provide them with resources and the opportunity to share practices and ideas.
When it comes to strategizing around public and private sector solutions to the opioid abuse crisis, FEMA Administrator Craig Fugate says it best: “No matter how much those of us in government do to prepare, we will only be successful if we engage the private sector as part of the team.”