Our Collective Role in Combating the Opioid Abuse Crisis: Public Sector Perspective (Part Two)

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 solving the opioid crisis and offer insight into innovative solutions that are transforming the battle against opioid abuse. In this series, we offer insight into the approaches that individual organizations can take to help combat this collective crisis.

The opioid abuse epidemic continues to put tremendous strain on nearly every corner of society. In part one of the series, we discussed the ways that the effects of opioid abuse span across families, friends, and the organizations and communities within which they interact. Within this ecosystem, the public sector—primarily the law enforcement agencies, departments of health, justice departments, and foster care systems—plays an especially critical role.

The public sector is also in a uniquely challenging spot within the context of the epidemic. 13 percent of Americans report that they’ve had a close friend or family member die from opioid overdose. These public sector agencies provide fundamental services to support those left behind in the wake of the epidemic. For example, as children are orphaned or removed from the increasing number of parents and caretakers struggling with addiction, the foster care system will inevitably feel the strain.

Citizens also inherently expect their elected officials to help find answers through policy and funding. Recent polls indicate that 63 percent of Americans believe state government is not doing enough to handle the crisis. While government agencies can, and should, continue to apply resources to combating the epidemic, more funding alone will not solve the crisis.

Rather than calling for the government to do more in its own public sector silo, we believe effective solutions stem from a collaborative approach across the public sector, physicians, insurers, and other community stakeholder groups—grounded in prevention, treatment, and enforcement. The public sector is uniquely positioned to sit at the center of this strategy.

Why is a holistic approach timelier than ever? In 2018, Congress approved $7.4 billion in funding for the opioid crisis. This package included a $3 billion increase to address the addiction crisis—making a total investment of $7.4 billion for 32 key programs to help fund a comprehensive response to the epidemic.

This money will be coming to states and localities in the coming months, and states should explore and plan for how to best use these dollars to create a sustainable, effective, long-term solution to this crisis that’s flexible enough to adapt to the next public health crisis.

We believe there are five core areas where the public sector can sit at the center of a unified strategy.

  1. Encourage coordinated care and ensure coordinated responses through strategy and strategic planning. Care coordination allows agencies to activate treatment and intervention strategies in counties and communities that have the highest volume or penetration per capita of accidental overdose deaths.
  2. Establish cross-agency collaboration and convene community stakeholder groups. In 2016, Baltimore created a multi-agency Fentanyl Task Force that meets monthly to develop new recommendations. One product of the group’s collaboration is a real-time alert system for overdoses, requiring contribution and collaboration between the police department, fire department, and other community partners. The group then targets education and outreach in areas with high incidence of overdose.
  3. Expand and improve treatment access by identifying, determining, and redirecting resources where they are needed, when they are needed, through data and analytics solutions. Given the siloed nature of public and citizen data, agencies are especially challenged to harness data, draw meaningful conclusions, and take the necessary action in real-time. Analytics can also enable a proactive approach through modeling which identifies those at high-risk to allow for intervention before overdose happens. Through Master Data Management and Advanced Analytics, states and local governments can more effectively allocate their limited resources and optimize them to expand and improve treatment access, while also saving money (cost avoidance).
  4. Increase use of, and improve interfaces, integration, and data sources for prescription drug monitoring programs (PDMP). PDMPs are statewide databases that provide prescribing and dispensing data from pharmacies and health care providers. Research has found that enhancing PDMPs with more robust features, including weekly data updates and closer monitoring, could prevent two deaths per day. Public agencies can play a role in establishing parameters and strategies that encourage doctors to use PDMP data before writing prescriptions, as well as greater data sharing across physicians and payors.
  5. Deploy new strategies with an underlying focus on change management. Focus on training current and future prescribers, community partners, and users that will be involved in deploying these solutions (county health departments, first responders, etc.) to ensure stakeholder buy-in and alignment around a unified approach.

From the private health insurance executive to the five-year old child orphaned due to her mother’s opioid abuse, the opioid abuse epidemic impacts a diverse group of stakeholders. As a multi-faceted problem, it requires multi-faceted, yet integrated solutions that engage all stakeholders. From analytics to cross-agency collaboration, we believe there are several key opportunities for states and localities to serve as a connector across the ecosystem—driving a holistic, strategic, and coordinated approach.