NYU experts address issues for tackling opioid crisis from wide range of perspectives
On February 15, NYU Law’s Health Law and Policy Society (HLPS) and Student Advocates for Empowerment through Harm Reduction (SAFER) hosted a panel discussion called “Combating the Opioid Crisis.” Sherry Glied, Dean of NYU Wagner, participated on the panel along with Mary Ann Chirba, Adjunct Professor at NYU Law; Holly Hagan, Professor at the Rory Meyers College of Nursing and Co-Director of the NIH Center for Drug Use and HIV Research at NYU; and Paul Testa, Chief Medical Information Officer at NYU Langone. Victoria Hamscho, a second-year law student and Academic Chair of HLPS, moderated the event.
The panel began with a simple question: how did we get here? Professor Hagan suggested that aggressive marketing of drugs like oxycontin had a large role in creating the epidemic. She also emphasized that physical, emotional, and sexual abuse are leading risk factors for drug abuse later in life, and that mental health services and social support are important factors to consider. Dean Glied added an economic perspective, explaining the epidemic in terms of supply and demand.
“The US has waves of addiction problems,” she said. “The demand for drugs is always out there.” In terms of supply, Glied said there are several categories: the supply of legally acquired prescription drugs, as well as supply of illegal substances like heroin and fentanyl. In essence, Glied explained, we’re dealing with two different epidemics.
Testa and Hagan provided a clinical perspective and pointed out that nurses and doctors typically don’t receive enough training on substance use. This is concerning given that a full 10% of adults have substance use problems—a number both Testa and Hagan believe is underreported.
The network of substance use treatment facilities, which often provides care that isn’t evidence-based or closely monitored, can be a poor alternative to treatment from doctors and nurses. “The treatment field is a weak field,” Dean Glied said.
Finally, the panel discussed the impact of federal action on the opioid crisis. They agreed that President Trump’s declaration of a public health emergency hadn’t had a big impact, and instead pointed to Medicaid and CDC research budget cuts.
“Money is actually going out of healthcare,” Chirba said, arguing that solving the opioid epidemic will take a comprehensive approach. Dean Glied pointed out that over 220,000 opioid users received insurance through the Affordable Care Act (ACA), and that recent changes to the ACA—as well as policy like Medicaid work requirements— threaten to leave drug users without a reliable source of care.
The wide-ranging perspectives of the panelists pointed to the need for addressing opioid use from many angles; it’ll take more than just policy, healthcare, or just physician training to make a real difference. “This remains an exquisite challenge that is taxing the system,” Testa said.