Search

Recent outbreaks of vaccine-preventable diseases (e.g., mumps and meningitis) among young adults at higher education institutions (e.g., university, college, and junior college campuses) have proliferated nationally. Collectively, they illustrate a pressing public health concern regarding low vaccination rates among higher education populations contributing to outbreaks of communicable diseases. A primary cause of these outbreaks are lax requirements for student vaccinations among higher education institutions as a requirement for matriculation. A series of inconsistences and failures concerning vaccination law or policy requirements among select higher education institutions lends to profound public health and ethical repercussions for students and community members. Against the backdrop of rising rates or outbreaks of vaccine-preventable conditions among institutional populations, addressing these findings is vital to alleviate future outbreaks on campuses and surrounding locales.

The US Centers for Disease Control and Prevention reported that more than 70 000 deaths from drug overdoses occurred in 2017, including prescription and illicit opioids, representing a 6-fold increase since 1999. Innovative harm-reduction solutions are imperative. Supervised injection facilities (SIFs) create safe places for drug injection, including overdose prevention, counseling, and treatment referral services. Supervised injection facilities neither provide illicit drugs nor do their personnel inject users. Supervised injection facilities are effective in reducing drug-related mortality, morbidity, and needle-borne infections. Yet their lawfulness remains uncertain. The Department of Justice (DOJ) recently threatened criminal prosecution for SIF operators, medical personnel, and patrons.

On October 26, 2017, the Department of Health and Human Services (HHS) formally declared a national state of public health emergency (PHE) in response to the opioid epidemic. Since renewed multiple times, HHS' PHE assimilates emergency declarations among a handful of state, tribal, and local governments. Countless public and private sector entities have engaged in additional opioid emergency response efforts across the United States. These emergency declarations and measures collectively respond to the worst PHE confronting the country since the origination of this specific emergency classification in 2001. Americans across all socioeconomic groups are at risk of, or already addicted to, opioids in one form or another. Several hundred thousand Americans have lost their lives to prescription or illicit opioid misuse over the course of the epidemic. Nearly 130 more Americans die each day from opioid misuse. Millions are directly impacted by excess morbidity arising from opioid use disorders (OUDs). Most people know someone who is at risk of, or has succumbed to, opioid abuse. This epidemic is truly the juggernaut of PHEs. While emergency responses to date are purposeful and often well-intended, for manifold reasons they have also proven inadequate in authorizing and funding sufficient, efficacious responses. More significant approaches and greater investments are needed to prevent excess mortality and morbidity. Commencing with an assessment of the impacts of the opioid crisis, existing legal and policy responses, and failures to control the epidemic, a series of interventions are proposed to (1) stymie opioid-related overdoses and deaths in real time and (2) obviate deleterious impacts for future generations.