What Can Pennsylvania Learn from the Opioid Epidemic?

May 12, 2022

It’s the worst part of my job as an emergency physician: witnessing how the pandemic has widened gaps in care for people struggling with substance use disorders (SUD). These gaps have resulted in thousands more overdose deaths since 2020. But that’s population data; there’s only one real statistic to the parents of a young adult suffering an accidental fentanyl overdose. “Accidental” refers to unpreventable, like a tsunami, and overdoses are preventable. If only my patients had been able to access care while in the chaos of addiction.

On April 12, 2022, the Pennsylvania House Health Committee hosted a public hearing on opioids in the commonwealth. The goals were to update lawmakers on the challenges of the rising death rate from fentanyl and other synthetic substances and to encourage clinicians, advocates, and state leadership to advance possible solutions. My testimony at this public hearing focused on the need to expand (1) low-barrier treatment access (via emergency department [EDs], peer-led engagement, and telehealth) and (2) harm reduction strategies (via naloxone, fentanyl test strips, and syringe service programs).

Multiple studies, including randomized controlled trials, have demonstrated the efficacy of medication-for opioid use disorder (MOUD); buprenorphine, especially, is arguably a more effective treatment for SUD than aspirin is for heart disease. Unfortunately, medications are underutilized due to provider- and patient-level barriers to treatment access that foil the best intentions. Appointments, insurance, transportation, and pharmacies can all stand in the way of the first dose of this life-saving medication.

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