Combating America’s Opioid Crisis
- Arun Gupta, MD
- Mar 27
- 5 min read
Updated: May 31
March 31, 2025
Arun Gupta, MD, Co-Author & Book Author
Tom O’Connor, Co-Author & Publisher
Topic:
Opioids are a class of drugs primarily used to manage moderate to severe pain. These substances can be derived from the opium poppy plant or synthesized in laboratories. Opioids alleviate pain by binding to receptors on nerve cells in the brain, spinal cord, gastrointestinal tract, and other organs throughout the body.
Since the 1990s, the United States has faced a rapidly escalating opioid crisis characterized by an increase in the overuse, misuse, and abuse of these drugs, leading to a significant rise in overdose deaths. The opioid crisis has become a profound public health emergency, formally recognized nearly a decade ago.
I am honored to have Dr. Arun Gupta as a co-author for this special issue. Dr. Gupta, with 35 years of medical practice, has witnessed firsthand the devastation caused by addiction and its impact on families. His primary focus is addressing the lack of access to care for individuals suffering from Opioid Use Disorder (OUD) and Substance Use Disorder (SUD) to help reduce overdose fatalities.
Dr. Gupta is the author of the highly regarded book The Preventable Epidemic: A Frontline Doctor’s Experience and Recommendations to Resolve America’s Opioid Crisis. He practices medicine in Monroe, MI, where he resides with his wife. They have three grown children, all of whom are medical doctors. Dr. Gupta also serves as the chairman of the board for the SOS Foundation, a nonprofit dedicated to reducing overdose deaths from opioid addiction and substance abuse.
Effective treatment of addiction is paramount to saving lives. We must collectively strive to close the chapter on the opioid crisis in America.
Additional Insights from Dr. Arun Gupta:
The current approach to the opioid epidemic is misdirected, resulting in over 1.5 million deaths in the past 25 years. Every day, more than 300 young, healthy Americans lose their lives to accidental poisoning, primarily from street fentanyl, which has become prevalent in the last five years.
The issue has been further complicated by mixed messaging from the government and big pharmaceutical companies. Addiction training was nonexistent in American medical schools and residency programs throughout the 20th century. Despite this, the Accreditation Council for Graduate Medical Education (ACGME) has failed to revise the medical school curriculum to address addiction training in the past 50 years. The American Society of Addiction Medicine (ASAM) estimates that 49 million Americans are at risk of dying from polysubstance abuse—an affliction that is treatable and preventable.
Currently, only about 2.4 million Americans receive addiction treatment, leaving millions untreated.
Buprenorphine (Suboxone, Zubsolv), an effective medication for combating opioid addiction, has been available since 2002. However, access to care remains restricted, and the treatment landscape has been hindered by the criminalization of opioid addiction treatment under the Drug Addiction Treatment Act of 2000. This legislation allowed physicians to take a course, pass an exam, and apply for an “X” waiver to prescribe buprenorphine, which I did in 2006. However, as OxyContin-related overdose deaths increased dramatically in the following years, concerns over the diversion of Suboxone led to stricter regulations.
By 2010, the national reduction in opioid prescriptions led to a spike in heroin overdoses, which escalated further, reaching 70,000 deaths by 2017. Despite these alarming figures, I was left with the question: “What can we do to prevent these overdose deaths?” Unfortunately, I did not find a satisfactory answer until I published The Preventable Epidemic: A Frontline Doctor’s Experience and Recommendations to Resolve America’s Opioid Crisis. Here is the link to the book. It is available in three formats: paperback, E-Book, and
Fentanyl, a synthetic opioid, is 100 times more potent than morphine. While it was once used to treat severe pain post-surgery, most fentanyl-related deaths today are caused by street-manufactured versions. The drug is often trafficked from China via open borders and is easily accessible on the streets.
Over the past three years, the death toll has soared to over 114,000 annually, with nearly all fatalities attributed to illicit drugs, not prescription opioids or doctors. However, the regulations established to curb pill mills continue to impede the ability of healthcare providers to adequately treat addiction, forcing patients to turn to the streets for relief. I have proposed for the past five years that street fentanyl should be reclassified as a class 1 drug. As I understand it, it is finally being discussed in Congress.
In December 2022, the U.S. government recognized the restrictive nature of the Drug Addiction Treatment Act of 2000 and passed the Medication Assisted Treatment (MATE) Expansion Act in June 2023. This legislation allows any physician without addiction-specific training to prescribe buprenorphine to any patient. However, the results have been underwhelming. There has been no significant increase in patient access to treatment, nor is there a reduction in the death rate over the past two years.
Telemedicine, widely expected to expand access to addiction care during the COVID-19 pandemic, failed to yield the anticipated results, as overdose deaths surged by 30-40% during this time. Despite these setbacks, I am proud to report an 85% success rate in my practice over the last 18 years. Many of my patients have returned to work, improved their education and skills, and rebuilt their lives with their families.
We distribute free Narcan (naloxone) nationwide to prevent overdose deaths, but it does not address the underlying issue of addiction nor ensure long-term recovery. While Narcan prevents overdose fatalities, it is not a cure. The costs of generic Suboxone are minimal—around $1 per dose—yet access to this life-saving medication remains severely restricted due to its current classification as a controlled substance. If Suboxone were made available without such restrictions, it could be dispensed more quickly, much like Narcan.
The solution is clear: we must train and equip healthcare providers to effectively treat addiction, particularly by incorporating addiction medicine into American medical schools. Training 20,000 new doctors per year, as we currently do, could significantly mitigate this crisis. However, with fewer than 7,000 addiction providers currently active in providing care to addicted patients, it is clear that systemic changes are necessary.
In my book, I outline a comprehensive plan to improve access to care and reduce overdose deaths. The research has already been conducted and published. The only thing required now is the will to implement these solutions without fear of bureaucratic overregulation.
This crisis is the most urgent humanitarian challenge of our time, and we must work together to prevent the destruction of American families due to accidental poisoning. It is time to take action and restore our nation.
Your Call to Action
To reduce overdose death rates across North America, we must be:
Providing access to professionals trained in medication-assisted treatment (MAT) for Opioid Use Disorder (OUD).
Collaborating with policymakers to establish practical and effective regulations for medications used in opioid addiction treatment.
Reducing the stigma surrounding addiction and its treatment.
Eliminating patient limits that restrict qualified healthcare providers from helping those in need.
Addressing resistance to addiction medicine education among healthcare providers.
Removing regulatory barriers that leave over 155,000 qualified medical professionals sidelined.
Additionally, we must fight the opioid crisis within our communities by:
Building community coalitions across sectors to address the opioid epidemic.
Establishing safe drug disposal sites to keep prescription drugs out of the wrong hands.
Creating drug diversion task forces to combat prescription fraud and illegal trafficking.
Training first responders to use naloxone (Narcan) to save lives.
Using drug courts to encourage treatment and reduce recidivism.
Implementing referral programs to help individuals voluntarily seek treatment.
Raising awareness about prescription drug monitoring programs (PDMP) to prevent “doctor shopping.”
Hosting community mobilization events to empower local sectors to fight the opioid crisis.
Summary
While mobilizing communities requires time and effort, it can drastically:
Reduce opioid overdose deaths
Decrease law enforcement costs
Increase productivity, and
Create safer environments for families and children.
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