The average life expectancy in the United States declined from 78.9 years in 2014 to 78.6 years in 2017.1 The 2017 figure—78.6 years—means life expectancy is shorter in the United States than in other countries.1 The decline is due, in part, to the drug overdose epidemic in the United States.2 In 2017, 70,237 people died by drug overdose2—with prescription drugs, heroin, and opioids (especially fentanyl) being the major threats.3 From 2016 to 2017, overdoses from synthetic opioids, such as fentanyl, fentanyl analogs, and tramadol, increased from 6.2 to 9 per 100,000 people.2
These statistics should motivate all health care professionals to improve the general public’s health metrics, especially when treating patients with substance use disorders. But to best do so, we need a collaborative effort across many professions—not just health care providers, but also public health officials, elected government leaders, and law enforcement. To better define what this would entail, we suggest ways in which these groups could expand their roles to help reduce overdose deaths.
Health care professionals:
- implement safer opioid prescribing for patients who have chronic pain;
- educate patients about the risks of opioid use;
- consider alternative therapies for pain management; and
- utilize electronic databases to monitor controlled substance prescribing.
Public health officials:
- expand naloxone distribution; and
- enhance harm reduction (eg, syringe exchange programs, substance abuse treatment options).
- draft legislation that allows the use of better interventions for treating individuals with drug dependence or those who overdose; and
- improve criminal justice approaches so that laws are less punitive and more therapeutic for individuals who suffer from drug dependence.
- supply naltrexone kits to first responders and provide appropriate training.
Kuldeep Ghosh, MD, MS
Rajashekhar Yeruva, MD
Steven Lippmann, MD