The Opioid Epidemic
https://www.nytimes.com/2018/11/25/health/opioid-overdose-deaths-dayton.html
https://www.theguardian.com/news/2018/nov/08/the-making-of-an-opioid-epidemic
In the United States today, the opioid epidemic has taken hold of every city and neighborhood. The epidemic began in the 1980s, and all throughout the 1990s and 2000s, pharmacological companies were pushing hospitals to administer drugs like OxyContin to provide instant pain relief. What ended up happening was the patients would develop extreme dependencies on these drugs, and their pain would worse the more they took. If they got off the drugs, however their pain would be unbearable. They would be stuck in an endless cycle of addiction. While this epidemic is not the same as an infectious disease, where sometimes mere contact can cause spreading, the opioid epidemic is caused primarily by addiction due to one-time exposure. This exposure can come in many forms, but the most common is prescription of an opioid-based pain-killer drug.
The Opioid epidemic is a public health epidemic in the US, and as such, the US government has, for the past few decades, been looking for ways to drive down the R_0 or basic reproductive number of the epidemic. In class, R_0 = pk, where p is the probability of infection. In this case, we can look at p as the probability of addiction after first time usage. This can probably be extended to probability of addiction after n-time usage, and that would be slightly more complicated, but an increasing function all the same, as the probability of addiction increases for each repeated usage. While in class k was posed as the number of contacts, we can look at k as the number of people with whom the drug was shared from one source person. As we noted in class, we can either reduce p or k. In this case, what public health officials did was reduce k, or the accessibility of the drug, since p is independent of human control. That is, we cannot control how likely a person is to become addicted; that is based on a variety of genetic and environmental factors.
In Dayton, Ohio, Mayor Nan Whaley believes that Governor John Kasich’s move to expand Medicaid in 2015 was instrumental in decreasing overdose deaths as it allowed access to free addiction and mental health treatment. Ohio as a whole is spending $1 billion a year to address the opioid epidemic. As such, one factor in decreasing k in Ohio was pouring resources into improving access to addiction treatment.
Additionally, Dayton has widely distributed naloxone (or Narcan, a drug that reverses opioid overdoses if administered quickly enough) all across the state (3300 total) and have held trainings all over to teach how to use it. Dayton also has an uncommonly large network of support groups and is investing heavily in peer support. All these efforts on the part of the Ohio government have lead to a 50% decrease in opioid overdose deaths in the last year, and the trend continues to be downwards. Other US cities could learn from Dayton, Ohio and instead of viewing such support systems as a costly ways to encourage drug use, could begin to view such measures as worthwhile investments to give victims another chance at life.