Demanding Better: A Case for Increased Funding and Involvement of State Medical Boards in Response to America’s Drug Abuse Crisis

The federal response to the U.S. drug overdose epidemic has largely focused on supply-reduction efforts. Yet, this response has led to serious consequences for patients, prescribers and the public. Specifically, demand-reduction activities have been inadequately prioritized and pursued, and supply-reduction efforts targeted at the prescribers of controlled medications have resulted in reluctance to prescribe medically necessary controlled medications, thereby compromising access to treatment. Meanwhile, overdose death rates have remained tragically high as unabated demand has yielded shifts in the supply of substances of abuse. This article reviews federal responses to the opioid crisis, examining the allocation of federal funding as well as the U.S. Department of Justice’s enforcement actions against health care providers. The article then provides recommendations for how state medical boards can be better utilized in responding to the overdose epidemic. These recommendations include requiring that state medical boards be the primary investigators of questions relating to medical need, allocating federal funding to state medical boards, instituting continuing medical education requirements for controlled medication prescribers and expanding screenings for problematic substance use.