HealthDay News — Fundamental reform of regulatory systems is needed to address the opioid crisis in North America and beyond, according to recommendations from a Commission report published online Feb. 2 in The Lancet.

Keith Humphreys, Ph.D., from the Stanford University School of Medicine in California, and colleagues focused on developing an analysis of the causes of and solutions to the North American opioid crisis.

The authors note that unless regulatory systems are fundamentally reformed, the profit motives of those inside and outside the health care system will continue to generate harmful overprovision of addictive pharmaceuticals. Opioids have a dual nature, offering benefit as well as risk, and this should be accounted for in drug regulation, prescribing, and opioid stewardship. Integrated evidence-based systems should be developed and supported financially for the care of substance use disorders. Long-term declines in addiction could result from fostering healthier environments (e.g., through programs for safe disposal of opioids, substance use prevention, and childhood enrichment). There is an urgent need for innovations in biomedical research into pain relievers and medications for opioid use disorder treatment, supply control strategies, and delivery of treatment for substance use disorders. High-income nations have a responsibility to prevent opioid manufacturers from encouraging opioid overprescribing in other countries.


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“It took more than a generation of mistakes to create the North American opioid crisis. It might take a generation of wiser policies to resolve it,” the authors write. “Such polices will have long-lasting gains if they curtail the power of health care systems to cause addiction and maximize their ability to treat it.”

Several authors disclosed financial conflicts of interest, including providing expert witness testimony.

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