Region Forward Blog

Sharon Zalewski: Cross-jurisdictional collaboration key to addressing the region's opioid epidemic

Mar 15, 2017


Since 1999, the rate of death related to opioid overdoses has quadrupled. In 2015, 33,000 Americans died from opioid overdoses, surpassing the number of fatalities from automobile accidents. The U.S. Department of Health and Human Services estimates that costs associated with opioid addiction exceed $75 billion annually.

These numbers do not begin to capture the daily impact that addiction has on families experiencing the decline of a loved one or the long-term impact caused by the untimely death of a parent, teen or young adult.

Opioid addiction was once considered a problem of poor, urban communities that was primarily attributed to the use of heroin and other illegal street drugs.  Addiction was associated with criminality, resulting in a stigma that prevented many from viewing it as a serious health issue. More recently, the opioid epidemic is being fueled by the significant increase in the use of legally prescribed opioids commonly used to treat chronic pain and other health conditions.  Overuse, misuse and abuse of legally obtained opioids, along with the steady availability of low-cost heroin, fentanyl and other illegally-obtained narcotics, has resulted in a public health crisis touching every community in the country. 

This is a factor in the significant increase in the opioid-related death rates (calculated as deaths per 1,000 people) occurring in this region. Opioid addiction is affecting people of all races and income levels from the District of Columbia to nearby suburban and rural counties in Maryland and Virginia. The death rate for all opioids is nearly equal for Black and White residents (6.4 and 6.8 respectively) and significantly lower for Hispanics and Asian/Pacific Islanders (1.5 and 1.1). The heroin death rate among Blacks is higher than among Whites (3.7 versus 2.5) while the non-heroin opioid death rate among Whites is higher than among Blacks (4.9 versus 3.5). The largest increase in opioid-related death rates are occurring in suburban communities.

The jurisdictional boundaries in this region are porous with residents regularly crossing borders for a variety of reasons including to obtain health services. Health information technology is now available to monitor medication prescribing and dispensing practices and facilitate the exchange of health information that will allow providers to identify individuals at risk for opioid abuse even if they cross from one jurisdiction to another.  Leaders recognize the interdependence of this region and that well-coordinated regional strategies will allow communities to leverage and use resource more effectively.

In October, District of Columbia Mayor Muriel Bowser, Maryland Governor Larry Hogan, and Virginia Governor Terry McAuliffe joined together in signing the National Capital Region Compact to Combat Opioid Addiction to address the impact of opioid addiction on area residents and promote cross-jurisdictional collaboration to address the opioid epidemic. 

In support of this collaboration, the Regional Primary Care Coalition is joining the Metropolitan Washington Council of Governments, CareFirst, and Kaiser Permanente to sponsor a Regional Opioid Summit on May 9. The Summit will bring together public health professionals, health and behavioral care providers, first responders, law enforcement officials, policy-makers and community leaders from across the region. It is our hope that together we will gain a better understanding of the opioid epidemic, identify strategies to reduce prescription opioid abuse, increase knowledge and understanding of the dynamics of addiction, and learn about evidence-based treatment and promising practices in early intervention, prevention, and public education.

Sharon Zalewski is the Executive Director of the Regional Primary Care Coalition, an active collaboration and learning community of local philanthropies and primary care provider coalitions working to advance health equity throughout Washington, D.C., Northern Virginia, and Suburban Maryland.

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