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Opioid medications, sometimes known as pain relievers, are the most widely prescribed class of drugs worldwide. While the United States represents about five percent of the world’s population, it consumes 80 percent of the global opioid supply. Not surprisingly, the U.S. is also suffering from the most severe opioid addiction and overdose crisis it has ever experienced. But, this didn’t happen overnight. Several factors contributed to the unprecedented use – and misuse – of opioids in this country.

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In a recent hearing before Congress, the Food and Drug Administration (FDA) Commissioner Scott Gottlieb spoke about the devastating impact of the opioid epidemic and what his agency is doing to address it. While Dr. Gottlieb is not the first to note the massive scale of this crisis, he did bring up one often-overlooked component of its much-needed solution – distinguishing between an opioid addiction and a physical dependence on opioids. Although frequently conflated, differentiating between these two conditions is essential to break the stigma associated with what has proven to be the most effective form of opioid addiction treatment: medication-assisted treatment (MAT) – a treatment approach that combines the use of medications such as methadone and buprenorphine with behavioral counseling.

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More than two million Americans are addicted to opioids, ranging from the illegal drugs heroin and fentanyl to the prescription medications OxyContin and Vicodin, yet eight times as many people misuse or are addicted to a substance that is more widely available and easier to access. This substance is alcohol. Despite the fact that it has largely retreated from public consciousness in the context of the current opioid epidemic, research shows that rates of alcohol misuse and addiction are on the rise.

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Our nation is in dire need of effective strategies to address the opioid epidemic. With this in mind, we published Ending the Opioid Crisis: A Practical Guide for State Policymakers. The goal of this guide is to replace misinformation and stigma with research-based facts and practical, health-based solutions in order to help state policymakers understand how they can implement a public health approach and solve this crisis.

Here, Lindsey Vuolo, JD, MPH, associate director of health law and policy at the Center, and lead author on this report shares additional thoughts about why this guide matters, what is wrong with a punitive approach and the important role states can play in ending the opioid epidemic.

Dr. Roy is an internal medicine physician board certified in addiction medicine and a clinical assistant professor at the New York University Department of Population Health. As the former Chief of Addiction Medicine for New York City jails, including Rikers Island, she oversaw addiction treatment and recovery efforts for the city's incarcerated men and women. Previously, she was on faculty at Harvard Medical School and a primary care doctor to Boston's homeless population, among whom the leading cause of death was drug overdose.

Following her participation in our Addiction Speaker Series, we interviewed Dr. Roy to learn more about drug addiction as it relates to the criminal justice system.

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