We are at the center of a complex and deadly opioid epidemic and the statistics are staggering. Since 1999, overdose deaths have quadrupled.

According to the Centers for Disease Control and Prevention (CDC), Americans are dying at a rate of 91 per day from opioid overdoses. A principal driver of these deaths is illicitly manufactured fentanyl that is 50 to 100 times more potent than heroin, and carfentanil, which is 1,000 times more potent than heroin.

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There were 62,000 opioid overdose deaths in 2016; drug overdose deaths have surpassed peak death counts of guns, HIV, and car accidents. Last year, our state of West Virginia saw a record 880 opioid deaths – the highest rate in the nation. In the fiscal year that ended in June 2017, officials in our state spent nearly

$1 million transporting corpses

.

This epidemic is a series of associated epidemics, an “epidemic of epidemics,” including hepatitis C and HIV; neonatal abstinence syndrome, which causes babies to be born drug-dependent; increased numbers of cases of endocarditis, an infection of the lining of the heart that may affect the heart valves, and osteomyelitis, a bacterial infection of the bone; children abandoned or neglected to an overwhelmed foster care system by caregivers; and falls and fractures in older adults. There are victims of all ages in this crisis.

Our local health departments are the boots on the ground. We urgently need emergency supplemental funding to reduce the death toll and spread of disease and harm in our state.

White House public health emergency declaration

The White House called attention to the severity of the opioid epidemic by declaring a public health emergency, and the need to address it in order to save lives. However, there is still an immediate need for a surge in resources, dedicated funding, and a coordinated federal, state, and local response.

However, the declaration of an opioid public health emergency and not a state of national emergency does not go far enough. Local health departments like ours are dependent on increased federal funding from the CDC to battle a public health crisis that seems to escalate daily.

We are fighting a battle in our communities without the resources we need to be effective. We have not seen the release of federal funds at the point of contact at the local health department level. Much more money is needed to implement the programs we know will help our communities.



ASTHO requests $1 billion in emergency supplemental funding

Our colleagues at the Association of State and Territorial Health Officials (ASTHO) recently requested the administration and Congress provide $1 billion over two years in emergency supplemental funding for the CDC to allow health departments to address the opioid epidemic.

Emergency supplemental funding would allow state and territorial health agencies to allocate additional resources for their top priorities, including:

Strengthening public health surveillance to improve our understanding of the epidemic.

Expanding opioid misuse and addiction prevention campaigns.

Linking electronic health records and prescription drug monitoring programs (PDMPs).

Expanding partnerships and collaboration with law enforcement.

Expanding access to naloxone and linking patients to medication-assisted treatment and other services.

We support ASTHO’s request and agree that more needs to be done to provide CDC, states and territories, and local public health agencies with investments in prevention to stem this public health emergency. Many local health departments at the county and city level receive funding for their activities through their state health departments.

Finding ways to efficiently deliver funding to local health departments is critical. The administration and Congress can make an immediate and meaningful difference in the opioid epidemic by allocating more funding to the hardest-hit areas of our nation, and no place has been more profoundly affected than West Virginia.



Local health departments like ours play a critical role in supporting the prevention of prescription and illicit drug overdoses by providing harm reduction activities including syringe exchange, by coordinating with community partners, clinical services, and law enforcement, testing our communities for hepatitis B, hepatitis C, and HIV, and through the distribution of naloxone to save lives of users and protecting the health of our first responders.

City, county, metropolitan, district, and tribal departments work every day to help ensure prevention and treatment options and resources are available to those affected by the opioid epidemic.

To do our job and protect the public’s health, we must have the resources and tools to accomplish what we know needs to be done. Emergency supplemental funding is critical to begin to turn the tide in our communities before another generation is lost from this unprecedented epidemic.



Michael Brumage, MD is the executive director of the Kanawha-Charleston Health Department, West Va. Michael Kilkenny, MD is the health director of the Cabell-Huntington Health Department, West Va.