In 2020, a special commission was convened to review causes and solutions for the increasing number of opioid deaths in North America. In February 2022, the Commission released its report.

Perhaps the most immediately distressing aspect of this report is the Commission’s estimation of loss of life through 2029. Starting with 2020 figures from the year the commission was convened, the Lancet-Stanford Commission estimates that there will be an additional 1.2 million deaths between that year and 2029. Their report covers the situations in both the United States and Canada.

Could this possibly be right? It could be. The total number of overdose deaths in America alone increased nearly 100% between 2015 and late 2021. In 2015, the total number of overdoses was 52,623. By September 2021, the estimated number of overdose deaths (when all autopsy reports are finally received by the CDC) is expected to be 104,288.

The Commission’s Focus: Opioids Only

The fact that the Commission is only focused on opioids makes this figure of 1.2 million additional deaths by 2029 even more chilling. America has seen an increase in deaths from cocaine and methamphetamine in addition to opioids, which means our total loss of life due to drug use would be even higher.

If the Commission proposes any methods of stopping this runaway freight train, those suggestions should be immediately and seriously considered.

The Commission defines eight domains that require brisk and decisive action to bring this disastrous situation under control. The first two relate to the control of opioid medication. The third domain relates to treatment for addiction. While each domain merits a close examination, to start with, here is an excerpt from that third domain, with a little extra formatting added.

Intro: The Commission notes the lack of accessible, high-quality, non-stigmatising, integrated health and social care services for people with opioid use disorder in the USA (and in Canada, to a lesser but still noteworthy extent).

1. This situation could be improved by financing such care through the mechanisms that support the rest of the health-care system. The Commission recommends reforming public and private health-insurance systems to address this issue, including cutting off funding for care that is likely to be harmful.
2. The Commission suggests that care systems should follow established models of chronic-disease management to promote many pathways to recovery from addiction.
3. It also calls for long-running disputes between factions in the field to be set aside, and urges these factions to unify under the banner of public health.
4. Finally, a major investment in workforce development is recommended—specifically increasing the number of addiction specialists and increasing the addiction-related knowledge and skills of general practitioners.

By their support for many pathways to recovery, many long-standing community and holistic programs may finally get greater recognition. And having more medical specialists in addiction treatment could also help. An increase in addiction specialists could mean that those in recovery could receive more discerning care than is possible when a general practitioner receives a DEA waiver to dispense buprenorphine. These two measures could both end up being enhancements to the North American effort to turn this catastrophic situation around.

News release on this commission.

Executive summary of this report.