Recommended Policy Changes to Transform US Response to Opioid Epidemic

As the nation moves into three decades of the overdose epidemic with renewed federal emergency declarations entering their sixth year and overdose deaths now exceeding 100,000 annually, it’s time to reckon with the limitations of our current policy approaches and adopt opportunities to reduce harm and improve lives.

With support from the Foundation for Opioid Response Efforts (FORE), public health law experts from Indiana University McKinney School of Law and the Temple University Center for Public Health Law Research at the Beasley School of Law present 84 opportunities for US drug policy reform at the federal, state, and local levels.  

The experts examined US drug policy using a “whole-of-government” approach that seeks to establish vertical and horizontal alignment of agencies, departments, administrations, practitioners, and others.  

“Our federal, state, and local governments are not sufficiently coordinating their efforts, either internally or with each other,” said Nicolas Terry, LLM, Hall Render Professor of Law at the Indiana University Robert H. McKinney School of Law and executive director of the Hall Center for Law and Health. “This is a list of ‘shovel-ready’ legal changes that policymakers can introduce tomorrow to promote effective cross-government action to reduce dangerous opioid use and its human and community toll.” 

The 84 opportunities are organized in an interactive table available and are accompanied by six white papers that describe a transformational model for US drug policy. The opportunities adhere to the components of the model:

1. Reimagine federal funding of substance use strategies to promote long-term state strategies and coordinated spending.
2. Remove the final “war on drugs” impediments from the treatment domain.
3. Accept that harmful substance use is not only a chronic condition but one that requires redesigning health care.
4. Build a modern harm reduction system and allow it to do its job with updated federal and state policies and the removal of structural barriers.
5. Identify and remedy the upstream social and structural determinants that operate both as root causes of substance use disorder (SUD) and impediments to treatment and recovery. 

“This project is filling a critical gap in drug policy work by showing us how policies at different levels and across different sectors can and must work in synergy to reduce overdoses,” said Karen A. Scott, MD, MPH, President of the Foundation for Opioid Response Efforts (FORE). We are pleased to support this important initiative that delves into an entire government approach, looking at what is needed to break down silos and produce effective change.”