Hi Deborah, Thank you for your comment. You point out the often experienced problem of policy makers not connecting the dots. Just like policy makers not connecting the dots that dismantling public health agency infrastructure leads to less healthy communities, they have not connected the dots that approving more powerful opioids will eventually lead to additional problems of substance misuse and abuse. It is imperative for all of us in the public health and population health communities to articulate how the dots are connected and directly communicate with policy makers with these facts. Thank you again for your comments.

Hello Mr. Bialek, You are correct, public health is expected to do pretty much everything with limited resources and no funding. As one working in public health, but with a clinical background in substance abuse treatment, which was before work in public health) Issues such as this continue to be cyclic with no plan to comprehensively address the epidemic from a prevention, community perspective and must be multi-faceted and include a bottom up approach targeting the community at many levels, policy, law enforcement, ecumenical, providers, patients and addicts etc. The question here is understanding that this is an epidemic which has received national attention, with funding tossed at this issue for now (an issue which has been around for at least 2 decades with limited funds available to address at that time, and if hx proves correct will change with new money and stop when funds stop) why then has the FDA recently announced that the FDA has approved manufacturing of opioid and/or opioid like medications that are stronger and more powerful than the current opioids which continue to addict and are the leading cause of overdose and death. This is a bit of an oxymoron and I was totally taken aback by this announcement (which was eased in during attention on the midterm elections and which have not been addressed by either party) and makes no sense. Given what we presently face I'm smh regarding how this latest manufacturing of stronger opioids is not addressed, is unchecked and allowed to happen. Not only should this be addressed from a multi-faceted level but also from a policy level and FDA approval and related manufacturing by RX companies should be shortstopped in its tracks. But then this is all about the money.