Applying principles of injury and infectious disease control to the opioid mortality epidemic in North America: critical intervention gaps

Author:

Fischer Benedikt1234ORCID,Pang Michelle54,Tyndall Mark67

Affiliation:

1. Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand

2. Department of Psychiatry, University of Toronto, Toronto, ON, Canada

3. Department of Psychiatry, Federal University of São Paulo (UNIFESP), São Paulo, Brazil

4. Centre for Applied Research in Mental Health and Addiction (CARMHA), Faculty of Health Sciences, Simon Fraser University, Vancouver, BC, Canada

5. Centre for Addiction and Mental Health (CAMH), Toronto, ON, Canada

6. British Columbia Centre for Disease Control (BCCDC), Vancouver, BC, Canada

7. School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada

Abstract

ABSTRACT North America has been experiencing an acute and unprecedented public health crisis involving excessive and increasing levels of opioid-related overdose mortality. In the present commentary, we examine current interventions (as existent mainly in Canada) to date and compare them against established intervention frameworks and practices in other areas of public health, specifically injury and infectious disease control. We observe that current interventions focusing on opioid drug safety or exposure—specifically those that focus on distinctly potent and toxic opioid products driving major increases in overdose mortality—may be considered the equivalent of ‘agent-’ or ‘vector’-based interventions. Such interventions have been largely neglected in favor of ‘host’ (e.g., drug user-oriented) or ‘environmental’ measures among strategies to reduce opioid-related overdose, likely contributing to the limited efficacy of current measures. We explore potential reasons, implications and remedies for these gaps in the overall public health strategy employed towards improved interventions to reduce opioid-related health harms.

Funder

Canadian Institutes of Health Research

Hugh Green Foundation Chair in Addiction Research

Faculty of Medical and Health Sciences, University of Auckland

Publisher

Oxford University Press (OUP)

Subject

Public Health, Environmental and Occupational Health,General Medicine

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