Is enough being done to tackle the opioid epidemic?
With approximately two million Americans abusing prescription drugs, the country is gripped in what has been described as an opioid epidemic. This incorporates the use of illegal substance heroin, alongside legal pain prescriptions, such as fentanyl, codeine, oxycodone and hydrocodone.
Originating in the 1990s to treat chronic aches and pains, the use of opioids has increased in prominence and popularity amongst the medical profession, when pain began to be seen as an issue for doctors to reconsider, with the release of drugs such as OxyContin and Percocet. The potency of these drugs also increased alongside this demand.
Pharmaceutical companies also responded to this demand in the creation of new drugs, with the notion that the use of opioids would be beneficial for patients and their ongoing treatment long-term. As a result, synthetic opioids, also began to hit the market with force, such as fentanyl, where increased volumes are manufactured in China and shipped over to the States.
Drug overdose has become a leading cause of accidental death in the US, with 52,404 lethal drug overdoses in 2015 alone, according to the American Society of Addiction Medicine, and 65,000 people in 2016. This widespread problem has therefore creating what President Trump has described as a “tremendous problem,” placing an increased strain on the US healthcare system.
The death rate of synthetic opioids other than methadone, including drugs such as tramadol and fentanyl, also increased by 72.2 percent from 2014 to 2015, according to the Centers of Disease Control and Prevention.
A change in perspective
The Washington Post has reported that opioids have become a $13 billion industry, which is only set to rise. With over two million citizens reported to have a substance use disorder and 591,000 using heroin, approximately 20,101 overdose deaths have been linked to the use of prescription pain relievers, with nearly 13,000 overdose deaths from heroin in 2015.
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There is now a call for healthcare providers, such as GPs to dentists to support this reduction in demand and a reversal in the use of opioids. Back in 2014, over 240 million prescriptions were written for opioids, the World Health Organisation reported, which has led to the government aiming to tackle the problem by warning health practitioners they could lose their medical licenses if they do not act in patients’ best interests.
Additionally, with measures put in place, such as the increased access to naloxone, which works to reverse the effects of an overdose and support user recovery, it has been used on a number of patients in the last year alone. GPs are also being monitored on the level of prescription drugs which are being prescribed.
Virginia’s secretary of Health and Human resources informed The Washington Times: We are looking at prescribing patterns, because sometimes it can be just a person or a group of people that are inappropriately prescribing. Sometimes it’s cultural: A region may just tend to prescribe more pain medication.”
The U.S. Department of Health and Human Services’ opioid initiative has also been implemented, in order to help patients and support their recovery from addiction. However, there is still a long way to go for individuals to access treatment – with a shortage of options and rising costs. The possible eradication of Obamacare could worsen this further, with possible rocketing health costs that could exclude thousands of individuals from accessing vital healthcare services. Consequently, the notion of increased funding in this area has been discussed to support lower-income families, alongside a tough approach to those found guilty of trafficking illegal drugs to support this ongoing trend.
Digital health passports - 4 quick facts
As COVID-19 vaccination programmes roll out around the world, policy makers and the private sector are engaged in intense debates over vaccine passports and whether they are the solution to re-opening economies and getting back to “normal”.
With various governments using different systems there is confusion over how universally accepted a digital health passport will be, and whether our private data will remain private. Here is we know about vaccination passports so far.
1. Many countries will require proof of vaccination status
Most international travel has been on pause during the pandemic, with strict quarantine measures in place around the world. For travel to "open up" again, it is likely that vaccine status, COVID-19 status or a combination of the two will be required before you're able to enter another country.
The European Union is behind a “Digital Green Certificate" that would enable people to show they have been vaccinated, had a negative test, or have recovered from the virus in order to travel across its 27 member countries, although MEPs have also said these will not be a precondition to exercise the right to free movement.
The UK is planning to use its existing National Health Service (NHS) track and trace app as a health passport for British people to travel abroad.
There are no plans to implement a nationwide health passport in the US so far, and there is fierce, partisan opposition to the idea; however Hawaii and New York State have launched passport programmes that enable vaccinated people to skip quarantine for inter-state travel.
Health passports are also being contemplated by the hospitality and entertainment industries - for example for entry to live music events and bars. Israel, which has the highest vaccination rate in the world, has launched a "green passport" for people to show at gyms, venues and synagogues, however there have been problems with access and data privacy.
2. They're not conventional passports - they're digital
Calling them "passports" is a bit of a misnomer, as most of the proposed certificates are digital. The CommonPass, for example, saves the user's test results onto their mobile device, along with any other necessary health screening information. The pass then generates a QR code which can be printed or scanned by airline staff to confirm the passenger's health status. It's already being used by major airlines including Lufthansa, United Airlines, and Virgin Atlantic.
In India, the health ministry has said that everyone who has been vaccinated will get a QR code-based electronic certificate.
Additionally China has implemented an app-based health code system that uses travel and medical data to give people a colour-based rating, showing how likely it is that they have COVID-19 and whether they should self-isolate.
3. Numerous tech companies have already created health passports
A number of tech companies big and small have already entered this space, with Microsoft’s CoronaPass, IBM’s Digital Health Pass, VaxAtlas and SafeFun among the many initiatives that have sprung up catering to different audiences - SafeFun is aimed at consumers to be able to socialise, while the SafeAccess app is specifically for workplaces.
This raises issues around standardisation - with so many different types of digital passport available, there will need to be consensus from venues, businesses and airports on how they work and whether they are accepted.
4. There are fraud and privacy concerns
Research by McAfee recently found a growing black market for fake COVID-19 test results and vaccination certificates.
Enforcing vaccine certification via an app would exclude people who do not own a smartphone. It also has the potential to reinforce existing inequalities, for example pregnant women, who are currently ineligible for vaccination in many parts of the world, and would therefore be unable to participate in the same activities as non-pregnant women.
Last but not least, many have raised concerns over data privacy, which is a major cause of the divisions over whether or not to adopt them. Experts have said they fear vaccination information could be linked to other personal data to create a “personal risk score” that could then be subject to abuse.