Public health responses to the opioid crisis in North America

The opioid overdose epidemic in North America remains among the most challenging public health issues of recent times. Sadly, all evidence points to a worsening of the epidemic,1 2 despite growing investment in responses that span policy and legislative changes, scale-up of evidence-based overdose interventions, and the implementation and evaluation of novel interventions. This has prompted concerns about what is and what is not being done to address this epidemic that has resulted in reductions in life expectancy in both the USA and Canada.

Given the well-described problem of the overprescribing of opioids for pain, governments and medical bodies have sought to reduce opioid prescribing through guideline development, physician education and monitoring efforts. While the rate of prescribing in the USA dropped from a high of 81.3 per 100 persons in 2012 to 58.5 per 100 persons in 2017,3 the death rate attributable to opioids continues…

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