How Public Health Informed Lawmaking Would Address the Rising Synthetic Opioid Death Toll

The sharply rising deaths associated with use of synthetic opioids in the United States highlight the failure of a legislative strategy focused on reducing the availability of prescription opioids. However, since synthetic opioids prescribed for pain relief have never been a major contributor to either developing opioid dependence or dying from opioid use, it is not surprising that these measures have not only failed to reduce deaths, but have also caused considerable harm to people in need of pain relief. Yet reversing them and taking a public health approach focused on preventing the most serious harms associated with synthetic opioids is hampered by the failure of the US legal system to adopt public health methods when legislating to address threats to the public’s health. Specifically, legislative initiatives are doomed to fail when they lack processes of setting legislative goals based on scientific evidence, reviewing the effectiveness of legislation in achieving these goals, or implementing changes when the goals are not being met.

This article identifies why the current method of using the legal system to address public health problems has made it so difficult to address the unacceptably high number of deaths associated with use of synthetic opioids and suggests how a different approach to law making could prevent future deadly failures.