President Donald Trump's drug commission—led by New Jersey Governor Chris Christie—is expected to issue an interim report today offering recommendations the government might take to reduce addiction and overdoses in the United States. The commission is a major part of the Trump administration's promises to end the U.S.'s opioid overdose epidemic, which killed more than 33,000 Americans in 2015.
The commission's work raised a question for us here at Pacific Standard: How many reports do we really need?
Over the past year and a half, various government agencies have issued at least four analyses of the opioid epidemic, totaling more than 800 pages. Below, we summarize some of the milestone drug reports the federal government has published recently, to see what new information each uncovered and where they're redundant.
Published by: The Centers for Disease Control and Prevention
Date: March of 2016
Length: This is an Internet document, but it registers at 39 pages when printed out
What was new in this report: CDC researchers review the science and suggest that opioid painkillers probably aren't the best choice for chronic conditions such as bad backs and necks. The researchers also suggest doctors use caution when prescribing high-dose opioids.
What was old news: By the time of the report's publication, treatment experts in the field were already engaged in a hot debate over whether opioids were good for chronic pain and whether there should be some sort of cap on the amount of opioids doctors should prescribe to their patients. Washington state published its own prescribing guidelines in 2015, but the CDC guidelines helped bring the issue to national attention.
Report name: Facing Addiction in America: The Surgeon General's Report on Alcohol, Drugs, and Health
Published by: The Surgeon General
Date: November of 2016
Length: 413 pages
What was new in this report: This was one of the first government reports on the current drug crisis to offer certain suggestions that would later become old hat: Needle exchange programs help prevent injection-drug users from contracting HIV, but don't encourage drug use; the American health system should better integrate physical and mental health care, including addiction care; doctors' groups should promote prescription drug monitoring programs. This report also summarizes what's known about the neuroscience of addiction, which we've seen no other general-audience report do.
What was old news: The report was supposed to sound the alarm about drug and alcohol addiction. The CDC guidelines had arguably already done some of that flag-waving, as had various news reports on addiction published by this time. But the way the CDC guidelines were written was aimed at doctors. The Surgeon General's report was written for all Americans.
Report name: Pain Management and the Opioid Epidemic: Balancing Societal and Individual Benefits and Risks of Prescription Opioid Use
Published by: The National Academies of Sciences, Engineering, and Medicine
Date: July 13th, 2017
Length: 372 pages
What was new in this report: It suggests some big changes to how the Food and Drug Administration treats opioid medicines it has approved in the past and will consider in the future.
What was old news: Outside of its recommendations to the FDA, the report echoes some ideas that have been floating around for a while now: that it should be easier for Americans to access evidence-based treatment for addiction, that it should be easier for Americans to get opioid-overdose-reversing medicine and clean injecting equipment, that the authors support state prescription drug monitoring programs, and that doctors' groups—such as medical schools and licensing boards—should teach health-care professionals about drug addiction.
Report name: Drug Control Policy: Information on Status of Federal Efforts and Key Issues for Preventing Illicit Drug Use
Published by: The Government Accountability Office
Date: July 26th, 2017
Length: 19 pages
What was new in this report: The Obama administration set seven major goals for drug use and addiction in the U.S. in 2010. This report gathered data on how well it met them. The verdict was "not well," a failure analyst Diana Maurer attributes to the severity of the opioid epidemic, for which officials were unprepared. This report offers one important recommendation we haven't yet seen before in a government report: To consolidate federal funding streams for projects meant to keep teenagers from using drugs.
What was old news: The report authors convened a panel of experts and asked them for suggestions for what the U.S. should do about drugs. We saw many of the same suggestions from before, including using evidence-based programs to prevent teens from using drugs, alcohol, and tobacco; getting family doctors to screen their patients for drug-use problems; and thinking of addiction as a brain disorder (the surgeon general's report was big on this).
So what have we learned from our tour through the history of the government talking about/worrying about/studying America's drug epidemic? We discovered many of these reports do offer their own, important perspectives on the problem. But we also found several of them echo one another's recommendations, suggesting that we already know what to do. Now, it's time to act.