Exploring Legal and Policy Responses to Opioids: America’s Worst Public Health Emergency

Abstract

On October 26, 2017, the Department of Health and Human Services (HHS) formally declared a national state of public health emergency (PHE) in response to the opioid epidemic. Since renewed multiple times, HHS' PHE assimilates emergency declarations among a handful of state, tribal, and local governments. Countless public and private sector entities have engaged in additional opioid emergency response efforts across the United States.

These emergency declarations and measures collectively respond to the worst PHE confronting the country since the origination of this specific emergency classification in 2001. Americans across all socioeconomic groups are at risk of, or already addicted to, opioids in one form or another. Several hundred thousand Americans have lost their lives to prescription or illicit opioid misuse over the course of the epidemic. Nearly 130 more Americans die each day from opioid misuse. Millions are directly impacted by excess morbidity arising from opioid use disorders (OUDs). Most people know someone who is at risk of, or has succumbed to, opioid abuse. This epidemic is truly the juggernaut of PHEs.

While emergency responses to date are purposeful and often well-intended, for manifold reasons they have also proven inadequate in authorizing and funding sufficient, efficacious responses. More significant approaches and greater investments are needed to prevent excess mortality and morbidity. Commencing with an assessment of the impacts of the opioid crisis, existing legal and policy responses, and failures to control the epidemic, a series of interventions are proposed to (1) stymie opioid-related overdoses and deaths in real time and (2) obviate deleterious impacts for future generations.

Keywords: opioids, law, policy, emergency, epidemic, crisis, intervention