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

“Progress on public health problems in a democratic society requires agreement about the mission and content of public health sufficient to serve as the basis for public action.” The rapid rise in deaths associated with drugs containing powerful illegally manufactured synthetic opioids during the SARS-CoV-2, (COVID-19) pandemic shines a powerful light on the failure of U.S. drug policies which seek to reduce prescriptions of legally manufactured pain medications. While no one has suggested that Covid-19 itself increases opioid-associated deaths, the social distancing that has reduced access to medical care as well as the social and economic losses that have increased feelings of despair that exacerbates risk of overdose. While others have identified the failure of laws that reduce the supply of opioids as having the paradoxical effect of increasing harms of not just overdose but also unnecessary suffering of those in need of prescription pain control medication, this is the first article to consider what taking a real public health based approach would look like. It does so by creating a taxonomy of harms associated with opioid use, identifying legislative interventions that would be most effective in addressing those harms, and then comparing this public health based schema with the laws that currently exist.