The Rosenthal Report - July 2018

Rosenthal Reports

In the July issue of the Rosenthal Report, we examine new data showing an apparent increase in drug overdose deaths in 2017 as the opioid epidemic continues to spread across country, and outline the essential components of a nationwide strategy to tackle the crisis. In news briefs, marijuana legalization rolls on and Big Tobacco bets on Big Pot.

2017 might become the deadliest year yet of the national opioid epidemic.

Provisional data from the Centers for Disease Control through the 12-month period ending November 30, 2017 indicate that about 200 Americans are dying every day from drug overdose, up from roughly 175 per day in 2016. If the trend continues through the end of the year, the finalized figures would bring last year’s annual death toll to nearly 73,000, the CDC predicts, an increase of 13.2 percent over the previous year. It is a grim reminder of the epidemic’s tenacious grip on the country – as well as, hopefully, a call to action to address this crisis.

The data shows worrisome trends in some states. Overdose deaths spiked 36 percent in Nebraska, which had previously reported a low rate, while New Jersey, a state that has implemented a robust anti-opioid strategy under former governor Chris Christie, saw an increase of 36.8 percent.  The death rate rose 27 percent in Indiana and in Pennsylvania (there were declines in Utah and Montana, at 15.1 percent and 7.2 percent, respectively.)

As noted by the Rosenthal Report, a number of cities and states have introduced innovative initiatives to confront the crisis, such as Rhode Island’s prison treatment program. But we’re failing on the national level. President Trump declared a national public health emergency last October. His opioid commission issued a report with nearly 60 policy recommendations. Then the president left details to be worked out by Congress. Last month, the House debated more than 50 bills and eventually consolidated and approved bipartisan legislation that includes dozens of proposals. This measure now goes to the Senate.

Unfortunately, the House bill is a grab bag of narrowly tailored items that, on their own, fall short of the full bore initiative we desperately need. The bill calls for more research into non-addictive pain medications; permits nurse practitioners and physician assistants to prescribe addiction withdrawal medications; and provides grants to help law enforcement test for the presence of fentanyl. While there is some good policy among its many provisions, they do not constitute a coordinated nationwide strategy nor do they significantly expand access to addiction treatment.

What’s more, there’s no additional funding beyond the $6 billion already set out in the $1.3 trillion budget deal approved in March. As the Senate considers the opioid legislation, these are the issues that must be addressed:


The federal government, perhaps through ONDCP (the office of the “drug czar”), should assume the role of national coordinator, overseeing development of state and city programs and funding across the country to ensure we are pursuing a comprehensive strategy, meeting goals and targets and exploring innovative approaches. 


Because only a fraction of those suffering from addiction receive any kind of treatment, we need to expand access to a broad range of treatment services including medication-assisted treatment, (MAT), which combines medication with behavioral therapy, along with outpatient and residential programs that employ peer-based counseling and long-term residential treatment for the most vulnerable patients.  


Instead of the $6 billion in the budget deal for 2018 and 2019, what is needed is something closer to the proposal of Senator Warren of Massachusetts and Representative Cummings of Maryland for $100 billion over the next decade to put the country on a war footing and ensure sustained support for efforts that combat the opioid crisis, using as a model HIV/AIDS legislation that boosted money to cities, states and the hardest-hit communities.

Sadly, we lost ground in 2017. More people died from overdoses and thousands more continued to struggle with addiction, unable to receive treatment that could put them on the road to recovery. This epidemic could be effectively reversed; we know what to do. What’s missing is the leadership and commitment to a coordinated, well-funded national program focused on treatment to bring it under control.


Canada’s parliament approved a long-awaited bill to legalize weed, and across the border in Vermont the state legislature approved the sale of recreational pot – the ninth U.S. state to do so. Meanwhile, New York City mayor Bill de Blasio decriminalized pot smoking in public. It can be difficult, however, to get a clear picture of public sentiment as laws change and politicians shift positions. For example, a recent poll of New Yorkers by Emerson College for the organization Smart Approaches to Marijuana, found that only 22 percent and 24 percent of Latinos and African Americans, respectively, support legalization. The survey also found that 76 percent of New Yorkers do not support pot advertising and 58 percent do not want marijuana stores in their neighborhoods.  


The British-based tobacco giant Imperial Brands has taken a stake in the U.K. startup Oxford Cannabinoid Technologies to research medical uses of cannabis, the Wall Street Journal reported. Analysts described the $13.1 million investment   as “the most significant among the global tobacco players in the cannabis industry to date.” Imperial, which owns the Winston cigarette brand, said the company’s interest is limited to medical uses of marijuana.




9th July 2018
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