In a NEJM Perspective, DPM Fellow Rebecca Haffajee, JD, MPH and colleagues discuss a recent declaration by the Massachusetts governor that the state’s opioid-addiction epidemic constitutes a public health emergency.
With this declaration, the state public health commissioner was able to use emergency powers to implement several actions including: expanding access to naloxone, an opioid antagonist that can reverse overdoses; developing a plan to accelerate the mandatory use of prescription monitoring by physicians and pharmacists; and prohibiting the prescribing and dispensing of an FDA-approved hydrocodone-only medication (Zohydro, Zogenix).
Once a public health emergency is declared, actions -- such as military deployment, restricting freedom of movement, or suspension of civil rights -- can be implemented without normal legislative approval or other checks and balances. Public health emergency powers are typically deployed if the scenario is exigent, if there is a high potential for catastrophic harm, and if avoidance of harm through ordinary means is not possible, such as with an Ebola outbreak or Anthrax attack.
The authors discuss whether or not it was appropriate to invoke emergency powers in the case of the opioid-addiction epidemic, since usual legislative procedures -- such as prescription-monitoring mandates and the drafting of related bills -- were already in process. Moreover, sidestepping the usual legislative process can result in legal actions under federal law. Zogenix, the manufacturer of Zohydro, brought such a challenge, stating that the governor’s ban on its product was unconstitutional and a federal judge ruled in their favor. Finally, although not clearly a concern with the Massachusetts opioid public health emergency declaration, overuse of this tool can infringe upon private business and individual rights, as well as compromise public trust in the government’s use of public health powers.
The authors believe that, although the governor’s declaration recommended prudent measures to ameliorate the opioid-addiction crisis in Massachusetts, it sets a disturbing precedent for the use of emergency powers to address certain public health problems.
For more interesting discussion and additional details on this topic, access the full article by clicking here.