Lancet Commission 2022: The Stanford-Lancet North American Opioid Crisis Commission

This Stanford-Lancet Commission report analyzes the history and trends of the North American opioid crisis, focusing on the insufficient regulation of the pharmaceutical and health care industries. Given that opioid-related morbidity and mortality have drastically increased in the United States and Canada over the past 25 years, the Commission—supported by Stanford University—aims to propose domestic solutions, prevent the international spread of the crisis, and develop a coherent, empirically grounded analysis of the causes of and solutions to the opioid crisis. In the mid-1990s, opioid prescribing quadrupled, particularly for extremely potent opioids for a range of chronic, non-cancer pain conditions. The Commission analyzed the crisis across seven domains: the crisis as a case study in multi-system regulatory failure; opioids’ dual nature as a benefit and risk to health; building integrated, enduring systems of care for people with substance use disorders; maximizing the benefits and minimizing the effects of the involvement of the criminal justice system with people who are addicted to opioids; creating healthy environments that allow long-term declines in addiction; greater innovation in response to the crisis; and preventing the North American crisis from spreading globally.

The Commission provides a series of evidence-based policy recommendations for each of these seven domains, specifically highlighting the need to reduce the power of health care systems to cause addiction and maximize their ability to treat and respond to it. The report is accompanied by an editorial article.